10/01/2025

An Update on Federal Appropriations and the Government Shutdown

The U.S. government shut down on October 1, 2025, after Congress was unable to reach a deal to fund federal agencies for Fiscal Year 2026 (FY26).

The shutdown impacts numerous health agencies and programs, including the Centers for Medicare & Medicaid (CMS), National Institutes of Health (NIH), National Cancer Institute (NCI), federally qualified health centers, and many social assistance programs.

Medicare Telehealth Services

With the government shutdown, the Medicare telehealth flexibilities expired on September 30 and Medicare telehealth rules will revert to those in effect prior to the COVID-19 public health emergency. Only beneficiaries in rural areas will be eligible to travel to a qualified originating site to receive telehealth services. No Medicare beneficiaries will be able to receive telehealth services in their homes. Additionally, audio-only services will not be covered.

Medicare Payments

Because Medicare is supported by mandatory funding, not annual appropriations, beneficiaries will still be able to access services and physicians can continue to submit claims, which will be paid. However, those payments may be delayed in a prolonged shutdown. The staff responsible for drafting and finalizing the annual Medicare payment rules, including the Physician Fee Schedule and Hospital Outpatient Prospective Payment System, will be furloughed, so the release of the final calendar year 2026 rules, which typically are expected around November 1, will be delayed in a prolonged shutdown.

For the latest information, physicians should monitor their MAC’s website and this CMS webpage. 

Impact on Cancer Patients 

During a government shutdown, essential services related to public safety, including inpatient and emergency medical care, do not stop. Mandatory spending that is not subject to annual appropriations, such as for Social Security, Medicare, and Medicaid also continues. 

The NIH Clinical Center remains open and will continue to provide care for patients currently admitted to the hospital. For more details about its operating status, visit cc.nih.gov. 

NIH will pause admitting new patients or processing grant applications but patients who are already enrolled in NIH/NCI clinical trials or receiving established cancer care will continue to receive treatment. Patients who are in clinical trials should contact their clinical trial coordinator or physician to confirm the status of their enrollment and follow-up appointments.  

Additional Impacts 

The U.S. Department of Health and Human Services (HHS) released a contingency staffing plan for its agencies ahead of the shutdown. These plans detail staffing levels and what each agency will be continuing or pausing during the shutdown.  

Major agency impacts include: 

• CMS. The agency will pause most oversight, policy and rulemaking, and beneficiary case work. 
  
  
• NIH. No new patients will begin treatment or be able to enroll in clinical trials, no new grants will be reviewed or issued, and all research activities, including basic and translational research, will pause. 
  
  
• CDC. No new grants will be issued, and public health data survey and reports will be delayed. 

• Work funded through user fees will broadly be able to continue. FDA activities related to imminent threats to the safety of human life will continue. However, the agency will be unable to accept new drug applications, or medical devices submissions that require payment of a user fee

To stay current on the evolving situation MSHO will provide updates as the become available. You may also visit ASCO in Action OR TAKE ACTION by visiting the ASH website to send a message to your elected officials about the need to reopen the government and finalize FY 2026 funding for NIH and other federal health programs.