Shutdowns, Claims, and Congressional Action: October Health Policy Updates

We are pleased to present the October issue of the ARN Health Policy Digest. This member benefit provides updates on health policy and legislative and regulatory developments that may be of interest to rehabilitation nurses.

Shutdown Showdown

The government shutdown commenced on October 1, 2025, when Congress was unable to pass a continuing resolution (CR) to keep the government funded. Prior to the shutdown, House Republicans passed a clean CR that would extend government funding at FY 2025 levels through November 21. Since then, Senate Democrats have continuously blocked the measure from advancing, despite holding 10 separate votes. In contrast, they released an alternative measure that would extend funding through October 31 and include provisions to extend Affordable Care Act (ACA) premium subsidies, roll back Medicaid cuts, and limit the White House's ability to make unilateral rescissions.

With no end in sight, both Republicans and Democrats show no signs of folding. ARN members should be aware of the harms of government shutdowns. The Department of Health and Human Services released its FY 2026 contingency staffing plan, detailing impacts on agency staff and services. Activities needed for safety and protection of property will continue during a shutdown; however, Medicare and federal research programs will be affected.

The federal government has laid off many furloughed employees as part of further reduction in force (RIF) efforts, including approximately 1,200 employees from the Department of Health and Human Services. A district judge in Northern California has blocked some of the layoffs, but Director of the Office of Management and Budget, Russ Vought, plans to lay off more federal workers as the shutdown continues.

Congress Weighs in on CMS Competitive Bidding

In September, ARN signed onto a letter addressed to Congressional leaders opposing the Centers for Medicare and Medicaid Services (CMS) and the Office of Management and Budget (OMB) proposal to include ostomy, tracheostomy, and urological supplies in Medicare competitive bidding. Recently, Representatives Greg Murphy (R-NC) and Neal Dunn (R-FL) sent a letter to CMS Administrator Mehmet Oz expressing their concerns regarding the inclusion of these supplies in competitive bidding and urging the agency to withdraw the proposal. The letter explains that the manufacturing of these supplies will be transferred to a foreign market harming American manufacturers, and that it will increase the costs of supplies and increase costs of managing health care complications.

Medicare Claims Hold

Starting October 1, 2025, CMS instructed all Medicare Administrative Contractors (MACs) to hold claims for 10 business days to avoid large-scale reprocessing of claims and delayed payment. Despite the ongoing government shutdown, CMS has confirmed that Medicare will continue to process and pay most claims on schedule, except for those impacted by the expired provisions. Those expired provisions, or "payment extenders", include payment for telehealth services, the additional payment for certain low volume hospitals, and additional pay for certain geographic regions of the country. To date, no payments have been delayed as statute already requires all claims to be held for a minimum of 14 days.

Notice of Funding Opportunities

Below is a list of other funding opportunities for interested ARN members.

• NINR Mentoring Resources and Activities (FOR-NR-25-003)
• Limited Competition: Community-Partnered Nursing Research Centers for Schools and Colleges for Nursing with Limited NIH Funding (P20 Clinical Trial Optional) (FOR-NR-25-006)
• Leveraging Nursing Research to Advance Healthy School Environments for All (FOR-NR-25-002)
• Advancing Nutrition-related Research Across the Lifespan (FOR-NR-25-001)
• Research Enhancement Award Program (REAP) for Health Professional Schools and Graduate Schools (FOR-PAR-25-420)
• Strategies to Improve Health Outcomes and Reduce Health Disparities in Rural Populations (R01 Clinical Trial Optional) (FOR-NR-25-007)
• Limited Competition: Ruth L. Kirschstein National Research Service Award (NRSA) Postdoctoral Research Training Grant for the Clinical and Translational Science Awards (CTSA) Program (T32 Clinical Trial Not Allowed) (PAR-25-195)
• Community Partnered Nursing Research Centers (P20 Clinical Trial Optional) (PAR-25-439)