October 2025
Government Shutdown Updates
On September 30, Congress failed to reach an agreement to fund the government, resulting in a shutdown that began on October 1. Congress has not yet been able to reach an agreement to reopen the government, and the timing of a resolution remains uncertain. There’s still no movement on a funding deal, with lawmakers remaining at an impasse over a spending bill and health care policy provisions related to the expiration of premium tax credits for the Affordable Care Act’s (ACA) marketplace.
Prior to the shutdown, the Office of Management and Budget (OMB) released a memo instructing federal agencies to prepare for reductions-in-force (RIF) targeting employees who work for programs not legally required to continue or are not consistent with the administration’s priorities. On October 10, the administration initiated layoffs of federal workers across the federal government, with approximately 4,200 federal workers across at least seven agencies receiving RIF notices; the administration has indicated that more layoffs are expected and could total more than 10,000. At the Department of Health and Human Services (HHS), it is estimated that as many as 1,700 workers, including many at the Centers for Disease Control and Prevention (CDC), received RIF notices so far. Reports indicated that about 800 CDC employees who originally received RIF notices later received emails rescinding their terminations and on October 15, a federal judge ordered the administration to cease all RIF notices and take no action to enforce the notices already issued while a lawsuit filed by federal employee unions proceeds.
Activities needed for the safety and protection of property are continuing during the shutdown. As the shutdown lingers, here is important information about how Medicare and federal research programs continue to be affected by the shutdown.
NIH Guidance for Extramural Community
On October 1, NIH issued a notice titled “Informationfor the NIH Extramural Community During the Lapse of Federal Government Funding.” The notice reiterates some information from the NIHcontingency staffing plan that was issued by the Department of Health and Human Services (HHS) ahead of the shutdown, and also provides some additional information about the status of key NIH activities. The notice provides information on impacted activities including management of current, active grants, eRA Commons, and grants.gov; drawdown of funds; reporting deadlines; no-cost extension notifications; submission deadlines; Office of Laboratory Animal Welfare operations; grant peer reviewing meetings; advisory council meetings; issuance of new awards and grant management activities; operations of the NIH Clinical Center; and NIH administrative functions, among others.
Medicare Claims Processing
Effective October 1, 2025, CMS instructed all Medicare Administrative Contractors (MACs) to hold claims with dates of service of October 1, 2025, and later for services impacted by the expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025. During the government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for services impacted by the expired provisions, including telehealth services, and certain claims paid to Federally Qualified Health Centers. To date, no payments have been delayed. Providers should continue to submit claims accordingly.
Telemedicine Services
The Medicare telehealth flexibilities enacted during the COVID-19 public health emergency expired on September 30. Therefore, Medicare payment for telehealth services has reverted to the payment rules in effect prior to the pandemic, as follows:
- Only beneficiaries in rural areas are eligible to travel to a qualified originating site to receive telehealth services;
- Beneficiaries cannot receive telehealth services in their homes; and
- Audio-only services are not covered.
If a provider wants to continue to offer telehealth services, the agency recommends that the provider asks the beneficiary to complete an Advance Beneficiary Notice of Noncoverage (ABN). The ABN is used to alert the beneficiary that if they wish to move forward with a treatment or a service, in this case a telemedicine visit, the cost of such service is the responsibility of the beneficiary.
It is important to note that physicians in certain MedicareShare Savings Program accountable care organizations (ACOs) can continue to provide and be paid for telehealth services.
Please click here for CMS claims processing information. ASH staff will continue to monitor the status of the government shutdown and will update the membership as needed.
Visit the ASH website to quickly send a message to your elected officials about the need to reopen the government and finalize FY 2026 funding for NIH and other federal health programs.
ASH and FDA Host Workshop on Regulatory Science in Hematology
On September 29 and 30, ASH and the U.S. Food and Drug Administration (FDA) co-hosted the third annual FDA-ASH Collaboration: A Workshop on Regulatory Science in Hematology at ASH Headquarters. Over the two days, a select group of 20 ASH participants explored the FDA’s role in hematology product development and key regulatory issues through interactive panels and case-based discussions. ASH was pleased to welcome the workshop co-chair Dr. Irene Ghobrial (ASH Subcommittee on Clinical Trials, Dana-Farber Cancer Institute), and FDA leaders and staff to educate and engage in meaningful dialogue with participants on topics such as clinical and translational research, trial design, and drug development.
ASH Signs onto Letter to Department of Homeland Security re: H1-B Visa Physician Workforce and Restriction of Entry of Certain Nonimmigrant Workers
On September 23, ASH, alongside over 50 stakeholder organizations, sent a letter to U.S. Department of Homeland Security Secretary Noem urging clarification in the guidelines that determines H-1B entry into the U.S. and to exempt physicians from the Proclamation entitled “Restriction of Entry of Certain Nonimmigrant Workers.” This Proclamation implements a $100,000 fee, to be paid by the prospective employer, upon initial application for an H-1B visa beginning on September 21, 2025. This cost will be burdensome to hospitals and health care systems that are already facing a physician workforce shortage. As 23% of licensed physicians in the U.S. are foreign-trained, H-1B physicians are a vital part of the health care system.
ASH Joins Sign-on Letter to Urge Congress to Extend the Advanced Premium Tax Credits
On September 15, ASH joined the AMA and 90 other medical societies and health care organizations on a letter to Congress advocating for the extension of the enhanced advance premium tax credits (APTCs). The enhanced APTCs help reduce the share that individuals and families pay toward coverage plans purchased through the Health Insurance Marketplaces. These enhanced credits have made health coverage more affordable for the more than 24 million Americans in 2025, many of whom are older, live in rural areas, or operate small businesses. ASH supports the APTCs as an important pillar of access to care and will continue to monitor this policy issue as a point of negotiation during the current government shutdown.
Dr. Anthony Letai Sworn in as NCI Director
Anthony Letai, MD, PhD, was sworn in as the 18th director of the National Cancer Institute (NCI) on September 29, 2025. Dr. Letai previously served as professor of medicine at Harvard Medical School and medical oncologist at the Dana-Farber Cancer Institute and has experience in the study of cell death in cancer, developing treatments, and identifying biomarkers. Following his swearing-in ceremony, Dr. Letai stated that he, National Institute of Health (NIH) Director Jay Bhattacharya, MD, PhD, and Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., “will work around the clock to identify cancer’s root causes, predictive biomarkers, and most effective treatments. Advances in understanding cell death and replication are essential to realizing President Trump’s vision for a healthy America.”