Beginning at midnight on October 1, 2025, the federal government came to a halt as Congress failed to reach an agreement to keep it open. Thousands of government employees were furloughed until further notice, and only critical operations will continue. Although the Senate met on Thursday morning to try to come to an agreement, they failed.
What does that mean for healthcare services and physical therapists working with older adults, many of whom are dependent on Medicare benefits? Fortunately, crucial health programs will continue to operate. Unfortunately, they will be significantly less efficient. The Department of Health and Human Services (HHS) estimated that over 32,000 employees (approximately 41% of its total staff) were furloughed on October 1, while approximately 15,000 employees were kept on to perform activities required by law.
Most of the “protected activities” during a shutdown include those dealing with the “safety of human life or the protection of property.” This includes staff overseeing mandatory Medicare and Medicaid activities, health care facility surveys in response to complaints of “the most serious incidents of resident or patient harm.”
The biggest impact to physical therapists is the loss of the ability to use telehealth services. As a result of multiple waivers implemented at the beginning of the COVID-19 public health emergency (PHE), physical therapists have had the ability to utilize telehealth for delivering services to patients when it was appropriate or necessary. Suddenly, a method of delivering skilled services for over five years is taken away and therapists throughout the country are scrambling to figure out how to ensure their patients keep access to therapy services. This abrupt ‘stop’ is also impacting other provider types since prior to the PHE, Medicare telehealth services were limited to people living in rural areas, and now in most cases, traditional Medicare beneficiaries will need to travel to see their providers in person.”
Of particular concern to home health agencies is the processing of comments on the Home Health Prospective Payment System (HH PPS) proposed rule for CY 2026. According to statute, CMS only has 60 days to review comments and respond to them. Since the comment period ended on August 29, 2025, CMS would normally be expected to publish the HH PPS final rule by October 29, 2025. However, some policy and rulemaking that CMS is responsible for will pause. Given the fact that the public submitted almost 16,000 comment letters, there is concern from the stakeholder community that publication of the final rule will be delayed.
Medicare beneficiaries don’t need to worry about their benefits, and healthcare providers will continue to be paid because the program has advanced appropriation funding through December 31, 2025. However, customer service inquiries may be less prompt and providers won’t be hearing from CMS personnel during the shutdown, and all outward communication from the agency is stopped.
Keep the heat on your members of Congressto come to an agreement to reopen the government and restore physical therapists’ ability to provide telehealth services. Join the Advocacy Network to continue to get updates or access the Legislation Action Center and Patient Action Center.
To learn more about the work of the Joint Government Affairs Committee or how you can get involved in advocacy, visit APTA Home Health or APTA Geriatrics.