As if their feet were set in concrete, congressional Republicans and Democrats are solidly entrenched in their opposing beliefs about government funding – and come midnight tonight, the federal government is expected to shut down unless an agreement is reached to fund it.
Looking ahead, federal agencies have contingency plans in place, although in some cases, a lack of funding would almost certainly impact some services.
Essentially, the stumbling block pitting Republicans against Democrats comes down to a stopgap spending bill to keep the lights on and the government funded through November.
On the other hand, Democrats indicated that they would eliminate for consideration their demand to include healthcare subsidies, such as those allotted under the Patient Protection and Affordable Care Act (PPACA), poised to expire at the end of 2025.
According to the Associated Press (AP), research and patient care at the National Institutes of Health (NIH) could be impacted. The AP reports that patient already enrolled in research programs will continue to receive care, although sick patients who might be expecting access to experimental therapies might not gain admission.
Payments for Medicare and Medicaid services are expected to continue, although a government shutdown could result in delays. The U.S. Department of Health and Human Services (HHS) has indicated that payments from the Children’s Health Insurance Program (CHIP) to eligible states will continue.
Meanwhile, the Centers for Disease Control and Prevention (CDC), which has been the topic of media attention recently, expects that half of its work population could be furloughed as a result of a government shutdown, according to the AP.
The elephant in the room is telehealth. Most healthcare authorities believe that telehealth will likely be impacted by a government shutdown.
“The uncertainly about telehealth puts telehealth physicians and telehealth support companies in a very difficult position,” said Ronald Hirsch, MD, in an email to RACmonitor.
Hirsch, a regular panelist and editorial contributor to RACmonitor, is also vice president of the Regulations and Education Group with R1 RCM Inc. Physician Advisory Solutions.
“Do they continue to provide services to Medicare beneficiaries, hoping that when a bill is finally passed … the coverage will be retroactive to October 1?” Hirsch asked. “Or do they pause their telehealth services, pivoting back to in person care, if that is even an option for them, as some doctors now have given up their office practice?”
According to historians, the last shutdown occurred during President Trump’s first term, lasting 35 days.
Meanwhile, I called my provider (Kaiser-Permanente), and my appointment tomorrow has not been canceled. At least, that what the pleasant lady said on the phone, as she hadn’t heard anything about a shutdown from her boss.
The U.S. Department of Education’s implementation of President Trump’s One Big Beautiful Bill Act (OBBBA) has triggered one of the most consequential – and controversial
Here’s the uncomfortable truth: many hospitals and state Medicaid plans, under pressure from HR1 data analysis needs, are paying eye-watering markups to for-profit CPA and
Please log in to your account to comment on this article.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
