Argentum continues to monitor the impact of the federal government shutdown on senior living communities and residents as it nears the three-week mark. The Senate voted down the House-passed continuing resolution (CR) for a 10th time this week, and is expected to hold votes this week on the CR paired with authorization to pay federal workers amid the shutdown. Democrats remain insistent that any CR must be paired with an extension of ACA enhanced subsidies that are due to expire at the end of the year, with these negotiations being led by Senator Jeanne Shaheen (D-NH). The House remains in pro-forma session to force the Senate to act on the CR it passed in September.
As a reminder, the shutdown impacts federal government services only, not state, county or local services. Each federal agency has prepared its own contingency plan outlining which operations will continue. Essential services are continuing, including Medicare, Medicaid, and Social Security, U.S. Mail service, and HHS staff for Medicare and Medicaid support. However, Medicare hospital-at-home and telehealth flexibilities had been extended only through September 30. As a result, the federal government is only processing and paying claims filed before the deadline, with statute requiring all claims to be held for a minimum of 14 days. Providers may continue to submit claims but may not be reimbursed for services if funding is not reinstated and some providers may discontinue services while payments are on hold. Importantly, CMS clarified a prior notice to remove references to physicians, ground ambulance transport providers and federally qualified health centers.
A result of the shutdown has also meant that several Argentum-led meetings with the administration have been indefinitely postponed, including a roundtable discussion between industry stakeholders and leading officials of the U.S. Department of Housing and Urban Development (HUD) that was to include the principal deputy assistant secretary, and the Office of Healthcare Programs deputy assistant secretary and associate deputy assistant secretary. Argentum had also scheduled meetings with the White House, CMS, and the Veterans Affairs department that were indefinitely postponed due to the shutdown. We are continuing to meet with legislative branch offices; however, many offices are limiting stakeholder meetings during the shutdown.
Additionally, the federal rulemaking process has paused, which has impacted the regulatory implementation of the pilot program to allow veterans to choose assisted living for their long-term care needs that was signed into law earlier this year. Argentum was scheduled to meet with the VA this month to discuss expediting the rulemaking process and expanding the program where possible.