10/16/2025

GOVERNMENT SHUTDOWN: Updates for Medicare & Housing Providers

The federal government remains shut down as of October 9, with Congress still deadlocked on a short-term funding bill. Affordable housing providers across the country are facing deepening uncertainty. With most staff at the Department of Housing and Urban Development (HUD) furloughed, critical payments for rent subsidies and housing contracts are delayed, putting older adults and low-income residents at risk. Meanwhile, the Centers for Medicare & Medicaid Services (CMS) released new guidance through its MLN Connects® Newsletter regarding Medicare operations during the shutdown.

Impact on Housing Providers

• Delayed Funding: Thousands of Section 8 Project-Based Rental Assistance (PBRA) contracts are pending renewal or reimbursement. These delays make it difficult for affordable housing communities—many serving older adults—to pay staff, maintain operations, and meet service needs.
• Operational Strain: Providers are making difficult decisions to cover expenses out of reserve funds or reduce nonessential services while awaiting federal guidance. For some organizations, cash flow disruptions threaten their ability to meet mortgage or utility payments.
• Residents at Risk: The prolonged closure is creating anxiety among residents who rely on federally subsidized housing. Many communities are working to reassure tenants that their housing remains secure while navigating uncertain timelines for federal support.
• Advocacy in Action: LeadingAge continues to urge Congress to end the shutdown and prioritize stable funding for affordable housing and senior services. The organization emphasizes that disruptions in housing programs disproportionately affect older adults with limited incomes, who depend on consistent, reliable support.

Medicare Operations Update

• Claims Processing: When legislative payment provisions (“extenders”) are scheduled to expire, CMS directs all Medicare Administrative Contractors (MACs) to place a temporary hold on certain claims for up to 10 business days. This routine measure ensures payments remain accurate and consistent with statutory requirements and should have minimal impact on providers due to Medicare’s 14-day payment floor.
• Telehealth Limitations: Without Congressional action, many pre-pandemic restrictions on telehealth services took effect October 1, 2025, excluding behavioral and mental health care. This includes prohibitions on providing certain telehealth services to beneficiaries in their homes or outside rural areas, as well as reinstating in-person requirements for hospice recertifications. Providers may continue to submit claims but should consider using an Advance Beneficiary Notice of Noncoverage when appropriate.
• ACO Exception: Clinicians participating in applicable Medicare Shared Savings Program Accountable Care Organizations (ACOs) may continue to provide and receive payment for covered telehealth services without geographic restriction, consistent with the Bipartisan Budget Act of 2018.

LeadingAge continues monitoring the shutdown through its serial page and the National Policy Pulse call each Monday at 3:30 p.m. ET. Please notify LeadingAge Ohio of any shutdown-related barriers so issues can be escalated to national partners.