Medicare stays online, but CMS pauses key services in shutdown 

WASHINGTON – The Medicare program will continue during the current government shutdown, but other activities, such as policy and rulemaking, may not continue, according to a contingency plan posted to the Centers for Medicare and Medicaid Services website. 

According to the plan, posted on Sept. 25, ahead of the shutdown at midnight on Sept. 30: 

Activities that will continue 

In addition to Medicare, other non-discretionary activities, including Health Care Fraud and Abuse Control and (HCFAC) and the Center for Medicare & Medicaid Innovation (CMMI) activities will also continue. 

CMS says it will have sufficient funding for Medicaid to fund the first quarter of FY 2026, based on the advance appropriation provided for in the Full-Year Continuing Appropriations and Extensions Act of 2025. 

Additionally, the agency says it will maintain the staff necessary to make payments to eligible states for the Children’s Health Insurance Program (CHIP) and will continue Federal Marketplace activities, such as eligibility verification, using Federal Marketplace user fee carryover. 

Activities that will not continue 

• Health care facility survey and certification: CMS survey and certification activities would focus on complaint investigations alleging the most serious incidents of resident or patient harm. Other survey activities, such as recertification surveys, initial surveys and less serious complaint investigations, as well as all surveys by federal staff, would be suspended. 
• Policy and rulemaking: CMS payment rule development and other policy decisions would depend on the funding source and duration of a lapse in appropriation.  With limited staff to review and provide operational support, the agency would expect delays in rule-making and other policy development.   
• Contract oversight: Under a lapse, CMS would be largely unable to provide oversight to many of its major contractors, including the Medicare Administrative Contractors, the Medicare Call Center and other IT contractors. 
• Outreach and education: Many national and community outreach and education activities performed by CMS would cease or slow down during a lapse. This could include local and national engagement activities, Medicare card and other mailings, and other beneficiary facing activities. 
• Beneficiary casework: CMS beneficiary casework services would largely suspend during a lapse in appropriations. 

During a shutdown, CMS will retain 50% of staff who are exempted (their activities or position are already funded or otherwise exempt) and 3% who are excepted (their activities are deemed necessary by implication). 

• Related: VGM Government Relations provided this rundown of the shutdown’s impact on the HME industry