Potential Government Shutdown and Telehealth Flexibilities Set to Expire

Published in Government Relations on September 29, 2025

September 30 represents an important date for HME providers for two reasons: 1) The potential of a government shutdown and how that affects HHS and CMS, and 2) the expiration of Telehealth Flexibilities unless a Continuing Resolution (CR) is agreed upon in time. 

HHS Outlines Contingency Staffing Plan During Potential Government Shutdown 

In preparation for a possible lapse in federal appropriations or a “Government Shutdown,” the U.S. Department of Health and Human Services (HHS) has released its comprehensive Contingency Staffing Plan. The plan details how the department will continue critical operations, which programs will continue, and which ones might be interrupted.  

HHS Staffing Breakdown Stats 

  • Total Employees Pre-Lapse: 79,717. 
  • Furloughed Employees: 32,460. 
  • Retained Employees: 47,257. 

Impact To HME Providers During A Government Shutdown 

For HME providers, the implications of a shutdown are primarily tied to Medicare, Medicaid, FDA oversight, and CMS operations. 

Services That Will Continue 

  • Medicare and Medicaid Claims Processing and Reimbursement: 
    These programs are funded through mandatory appropriations, so claims processing and payments to HME providers will continue. This ensures that providers can still receive reimbursement for covered equipment and services. 
  • FDA Oversight of Medical Devices: 
    The FDA will continue critical functions such as: 
    -Emergency response to product recalls. 
    -Monitoring for adverse events. 
    -Screening imported medical products.  
    These activities help ensure that HME products remain safe and compliant.
  • CMS Core Operations: 
    CMS will retain staff to support mandatory activities, including oversight of Medicare contractors. However, some oversight functions may be limited, potentially delaying audits or reviews. 

Services That May Be Disrupted 

  • Grant and Contract Processing: 
    HHS will suspend non-exempt activities, including processing of new grants and contracts. This could affect providers involved in federally funded pilot programs or research initiatives as well as delaying new contracts.  
  • Public Communication and Data Analysis: 
    Agencies like CDC and CMS may reduce public-facing communications and data analysis. This could impact access to updated guidance or utilization data relevant to HME providers. 

What Can You Do?  

  • Continue submitting claims as usual.  
  • Monitor CMS and FDA updates for any changes in guidance or operations.  
  • Prepare for possible delays in non-essential communications or contract-related activities. 

Telehealth Flexibilities Set To Expire September 30. 

Congress has until September 30, 2025, to extend or make permanent important telehealth flexibilities that lifted geographic and originating site restrictions on telehealth services for Medicare beneficiaries and providers. As a refresher, the current extension preserves several key policy modifications:

  • Removal of geographic restrictions and the expansion of originating sites to include the patient’s home. 
  • Broadening of telehealth eligibility for practitioners. 
  • Allowing audio-only telehealth for some services. 
  • Continuing telehealth services for FQHCs and RHCs. 
  • Delay of in-person requirements for mental health services and hospice care recertification. 
  • Extension of the Acute Care Hospital at Home program, providing inpatient services outside of a hospital. 

What Happens On October 1?  

CMS has confirmed that beginning October 1, 2025, Medicare will revert to pre-PHE regulatory standards, unless specific provisions have been extended by legislation or CMS rulemaking. 

  • Patients must be at an approved originating site such as a rural clinic, hospital, or federally qualified health center for most telehealth services to be reimbursed. 
  • Home-based telehealth visits for most specialties will no longer be covered unless the patient meets very specific exceptions. 
  • Audio-only visits are no longer broadly payable. The telephone E/M codes 99441 to 99443 were deleted. 

What Can You Do?  

1. Review Current CMS Guidance 

Check the latest CMS updates to confirm which flexibilities have expired and which may have been extended or modified. Pay close attention to: 

  • Face-to-face visit requirements. 
  • Documentation standards for medical necessity. 
  • Telehealth billing codes and modifiers. 

 2. Update Internal Policies 

Ensure your intake, documentation, and billing procedures reflect the reinstated requirements. This may include: 

  • Requiring in-person visits for certain DME prescriptions. 
  • Adjusting workflows for patient assessments. 
  • Training staff on new compliance protocols. 

3. Communicate With Referral Sources 

Educate physicians and discharge planners about the return to standard documentation and face-to-face requirements to avoid delays in equipment delivery. 

4. Monitor Legislative Activity 

Some flexibilities may be reinstated or extended through congressional action such as the CONNECT Act or the Telehealth Modernization Act. Stay engaged with VGM Group, AAHomecare, and other industry groups for updates. 

 5. Audit Recent Claims 

Review claims submitted under telehealth flexibilities to ensure compliance and avoid future audits or denials. 

For additional questions, reach out to VGM. We will continue to monitor this situation closely and keep you up to date with any developments as they occur.  

From Our Experts

Legislative Momentum in the HME Industry: Key Updates & Action Items thumbnail Legislative Momentum in the HME Industry: Key Updates & Action Items The past few months have seen a surge of legislative activity in the home medical equipment sector, with several key developments shaping policy and advocacy efforts across the industry. From new bills introduced in Congress to formal comment submissions and stakeholder mobilization, these events reflect growing momentum around critical issues affecting providers and patients alike. This article offers a comprehensive recap of recent actions and outlines important next steps for those... VGM Submits Comments Regarding the Section 232 National Security Investigation On Medical Imports thumbnail VGM Submits Comments Regarding the Section 232 National Security Investigation On Medical Imports VGM has submitted formal comments to the U.S. Department of Commerce in response to its Section 232 National Security Investigation into the importation of personal protective equipment (PPE), medical consumables, and medical equipment and devices. Senate Backs DME Relief Act with Bipartisan Support thumbnail Senate Backs DME Relief Act with Bipartisan Support In a significant development for the durable medical equipment (DME) industry and Medicare beneficiaries, the U.S. Senate has introduced S.2951, the companion legislation to H.R. 2005, known as the DMEPOS Relief Act of 2025. The Senate bill is being led by Senator James Lankford (R-OK) and has gained bipartisan support with Senator Maggie Hassan (D-NH) joining as a co-sponsor. Gov't Shutdown: What It Means for Providers thumbnail Gov't Shutdown: What It Means for Providers As expected, Democrats and Republican members of the Senate was unable to agree on terms in passing a continuing resolution (CR) ahead of the October 1st deadline, resulting in a government shutdown. But how did we get here? Oppose DMEPOS Bidding Expansion – Take Action Now thumbnail Oppose DMEPOS Bidding Expansion – Take Action Now A critical Congressional Sign-On Letter is now circulating in the House of Representatives, led by Reps. Neal Dunn (R-FL) and Greg Murphy (R-NC). This bipartisan letter calls on CMS to stop the proposed expansion of the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) Competitive Bidding Program to include ostomy and urological supplies. Josh Turek Visits VGM to Champion Accessibility & Advocacy thumbnail Josh Turek Visits VGM to Champion Accessibility & Advocacy Waterloo, IA — On Monday, VGM Group hosted the first of our “Meet The Candidate” forums by welcoming Iowa State Representative Josh Turek, a Democratic candidate for the U.S. Senate seat soon to be vacated by Senator Joni Ernst. VGM & NCART Rally in D.C. to Defend CRT & HME Access thumbnail VGM & NCART Rally in D.C. to Defend CRT & HME Access Washington, D.C. – September 2025 — A powerful few days of advocacy wrapped up in the nation's capital as representatives from VGM Group, NCART, AAHomecare, and other key stakeholders in the Complex Rehab Technology (CRT) and Home Medical Equipment (HME) industries met with lawmakers to address urgent policy concerns. Igniting Champions Of Change During August Recess thumbnail Igniting Champions Of Change During August Recess This August recess, DME suppliers across the country seized the opportunity to engage with lawmakers and advocate for critical DMEPOS legislation. Their efforts are helping to build momentum and expand the network of congressional supporters.