Following the federal government shutdown on October 1, the Centers for Medicare & Medicaid Services (CMS) has released details outlining which activities will continue and which will be paused during the lapse in funding. About 53% of CMS staff—approximately 3,300 employees—will remain active to support essential operations.
What Will Continue:
- Medicaid Funding: CMS has sufficient funds to support Medicaid payments through the first quarter of fiscal year 2026, ending December 31.
- CHIP Payments: Funding and staffing will continue to ensure payments to eligible states under the Children’s Health Insurance Program (CHIP).
- Federal Marketplace Operations: Activities such as eligibility verification and enrollment will proceed.
- Key Program Functions: Non-discretionary operations, including Health Care Fraud and Abuse Control and the Center for Medicare & Medicaid Innovation, will continue.
What Will Be Paused or Limited:
- Facility Surveys: Inspections will focus only on serious incidents of patient or resident harm. Routine surveys and lower-level investigations will be suspended.
- Policy and Rulemaking: Expect delays in policy development and regulatory updates due to limited staffing.
- Contract Oversight: Oversight of major CMS contractors, including Medicare Administrative Contractors and call centers, will be reduced.
- Outreach and Education: Many outreach and education initiatives, including certain mailings, may be delayed or paused.
- Beneficiary Services: Most direct case services for beneficiaries will be temporarily suspended.
Healthcare providers should be aware of potential delays in communication, policy updates, and certain CMS activities until government funding is restored.
Resource: The CMS activities that will, won’t continue during the shutdown