With the end of the federal fiscal year (September 30) fast approaching, Congress has not yet come to an agreement on a continuing resolution (CR) to temporarily fund the government until new funding legislation can be passed and signed into law. Typically, the government and its agencies will prepare contingency plans outlining how essential government services will operate during a shutdown. To date, neither departmental contingency plans nor agency lapse plans have been publicly released for fiscal year 2026 (FY26), though it has been reported that the Office of Management & Budget (OMB) has received many of them from other agencies.

LeadingAge has been reviewing prior years’ contingency plans to help anticipate how aging services may be impacted by a shutdown; however, we caution that the Trump administration has demonstrated willingness to depart from standard procedures and is likely to do so in this case. Below, we explore the contingency plan from the Department of Health & Human Services (HHS) and lapse plans from the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control & Prevention (CDC).

Impact on HHS Programs

As of September 26, an updated contingency plan for HHS has not been publicly released. LeadingAge has analyzed the most recently available contingency plans and agency lapse plans for CMS and CDC, last reviewed in December 2024, as guides for what we could potentially expect for programs under these agencies if Congress fails to pass a CR by September 30 and the government enters shutdown.

Activities that May Continue: Under the FY25 CMS plan, activities under the mandatory Medicare program and nondiscretionary Health Care Fraud and Abuse Control and Center for Medicare & Medicaid Innovation would continue. CMS anticipated in FY25 that Medicaid would continue to be funded for the first quarter, with program reductions occurring in any subsequent quarters of a shutdown to allow only for regular Medicaid grant awards made within 30 days of the initiation of the lapse based on Section 111(b) of Public Law 118-83. This funding, however, was based on advance appropriation from FY24 and similar advances may not be available from FY25. Federal Exchange activities such as eligibility verification, funded by Federal Exchange user fees, were also anticipated to continue under CMS’ FY25 plan.

Under the FY25 CDC plan, response to outbreaks, laboratory functions, and CDC’s 24/7 emergency operations center were to continue. HHS also anticipated using the full extent of the authority under the Antideficiency Act (ADA) to continue immediate response to urgent disease outbreaks and critical investigation needs in areas such as food, health care, vectors (mosquitoes and ticks), and high-consequence pathogens. CDC would also continue collecting data reported by states and other entities.

Activities that May Not Continue: Under the FY25 CMS plan, Health Care Facility Survey and Certification were to be adjusted according to CMS tiered priorities. Policy and rule-making would depend upon the funding source, but with limited staff, CMS cautioned that delays would be expected. Contract oversight would be paused or severely limited, impacting the Medicare Administrative Contractors (MACs), the Medicare Call Center, and other IT contractors. Outreach and education activities would have been paused but we note that with the continuing HHS communications freeze that has been in place since January 2025, many of these activities have already ceased. Under the FY25 lapse plan, CMS beneficiary casework would also be largely suspended.

Under the FY25 CDC lapse plan, technical assistance to state and local health departments, applied public health research to improve prevention modalities, response to public inquiries on public health matters, and analysis of surveillance data for reportable diseases would all be suspended. Year-end surveillance reports would be delayed.

What This Means for LeadingAge Members

Medicare payments fall under mandatory spending and are therefore not impacted by a lapse in appropriations. While the MACs, who are responsible for Medicare claims processing and payment, are impacted by a government shutdown, it is anticipated that processing and payment of Medicare claims would be a prioritized function addressed by staff who are exempt or excepted from furlough.

Nursing homes’ off-cycle revalidations are also processed by the MACs, and while the processing of these forms would likely be paused or delayed by a government shutdown, it is important to note that CMS has not announced an extension for this requirement. At this time, nursing homes are required to submit off-cycle revalidations by January 1, 2026. Similarly, if you have submitted your off-cycle revalidation and additional information has been requested by the MAC, you should continue to comply with the MAC’s deadline regardless of a government shutdown.

While the respiratory virus dashboards maintained by CDC will likely not be updated, as “analysis of surveillance data” were expected to be paused under the FY25 lapse plan, collection of this data was expected to continue. Considering this, and because CMS has not otherwise announced a waiver of requirements, nursing homes should continue reporting respiratory illness data for residents and vaccination data for staff into the National Healthcare Safety Network (NSHN).

If consistent with the FY25 lapse plan, survey and certification activities would be limited to Tier 1 priorities. CMS outlines tiered priorities in the FY 2026 Mission and Priorities Document. For nursing homes, this means that only complaint investigations triaged as Immediate Jeopardy would be conducted. Standard recertification surveys, initial certification surveys, and complaint investigations triaged at a level lower than immediate jeopardy would be paused. For home health and hospice providers, surveys that are approaching the 36.9-month maximum interval would be conducted. Initial certification surveys and surveys adhering to the 24.9-month average interval would be paused.

The Hospice Outcomes and Patient Evaluation (HOPE) tool is scheduled to be implemented October 1. At this time, CMS has not announced an extension for this requirement. LeadingAge will be watching for changes, but hospice providers should be prepared to comply with this deadline until further notice.

The calendar year 2026 (CY26) Home Health Payment Rule is expected to be finalized in late October/early November for implementation beginning January 1, 2026. Recall that the CMS lapse plan states that rule-making and policy-making would be delayed or paused; however, we believe that finalization of this rule could be a prioritized activity.

Recalling that these plans are outdated and are only a guide for how things have been done in the past, LeadingAge will continue to monitor for updated plans from HHS and any other changes from the Administration.