The eighth day of the federal government shutdown was marked by another round of failed votes on a pair of dueling funding bills.
Here are four updates to know on the government shutdown as it entered its second week:
1. Impasse continues
For the sixth time, a pair of funding bills was rejected by the Senate, Politico reported Oct. 8.
The House-passed version of the bill, supported by Republicans, would extend several key healthcare programs through Nov. 21, including the Medicare-dependent hospital and low-volume adjustment programs, telehealth and hospital-at-home flexibilities, and the Cybersecurity Information Sharing Act. The bill does not address the ACA premium tax subsidies that are set to expire at the end of the year.
Senate Democrats’ proposal — which would fund the government through Oct. 31 — includes additional healthcare funding, including the extension of the ACA subsidies.
A seventh round of votes is expected Oct. 9 and the same result is expected, according to the report.
The House has been out of session all of October and Speaker Mike Johnson, R-La., said he would not call the chamber back into session until the Senate passes the House version of the bill, according to the report.
2. Some health systems pause Medicare telehealth
Pandemic-era telehealth flexibilities expired Oct. 1, cutting off CMS reimbursement for many virtual visits. While many health systems are awaiting a funding resolution, the American Telemedicine Association estimates that about 30% of hospitals and health systems have halted their Medicare telehealth offerings amid the shutdown.
Renton, Wash.-based Providence told Becker’s it proactively prepared for telehealth services to return to prepandemic guidelines and some Medicare patients are being asked to come in for appointments that were originally scheduled as telehealth to ensure their care is covered.
Other systems, such as Chesterfield, Mo.-based Mercy, are anticipating back pay from CMS once the shutdown ends. Mercy told Becker’s it remains committed to provide telehealth services and “hopes to receive reimbursement retroactively when the government reopens.”
3. Health systems scrambled to discharge hospital-at-home patients
CMS reimbursement also lapsed for hospital-at-home services Oct. 1, requiring health systems to discharge or transfer Medicare beneficiaries by midnight, sending many patients back to capacity-strained facilities.
Among them is Rochester, Minn.-based Mayo Clinic, which had to transition or return its roughly 30 hospital-at-home patients in Arizona, Florida and Wisconsin to its facilities. The health system is now focusing on outpatient, high-acuity hybrid care at home, including early discharge after 48 hours, oncology, emergency department avoidance, postprocedure treatment and urgent care.
4. Organ transplant network faces disruption
The federal government directed the United Network for Organ Sharing to pause some of its oversight work amid the government shutdown. As the primary contractor for the Organ Procurement and Transplantation Network, UNOS manages the nation’s organ donation and transplant system, facilitating matches and monitoring patient outcomes.
While critical services — including operation of the organ matching system and responding to serious patient safety risks — will continue, the OPTN has been ordered to pause much of its routine oversight responsibilities. One specific area of work being paused is the monitoring of reports for policy implementation on heart and lung transplants.
Giles Bruce contributed to this report.
