College of American Pathologists




October 1, 2013
© 2013 College of American Pathologists
Special Report
CAP Update from Washington on the Government Shutdown

October 1, 2013—Today, the U.S. government has begun to shut down activities after a Congress bitterly divided over President Obama’s signature health care initiative failed to reach agreement to fund federal agencies.

But while the government begins to shut down, CAP is here working on behalf of its members and communicating with Members of Congress and our advocacy partners. As deliberations continue and we await further news of a resolution, CAP continues to push its advocacy agenda with Members of Congress and senior officials at regulatory agencies such as CMS and FDA, who are all working through the shutdown.

So how might the shutdown affect you?

As the federal government is forced to shut down as a result of a budget impasse in Congress, discretionary programs and federal employees will be the most affected, while payments for Medicare and Medicaid services, insurance exchanges created by the Affordable Care Act (ACA), and other mandatory programs would continue, likely at a slower rate if the government were to undergo a long term shut down.

The American Medical Association (AMA) has done a thorough analysis of the implications of the shutdown, included below:

Activities That Will Continue Under the Government Shutdown:

  • The Affordable Care Act (ACA) will continue to be implemented. On October 1, state insurance exchanges officially opened for enrollment.
  • Medicare and Medicaid Implications:
    • Funding Remains Mandatory. In the short-term, the Medicare program will experience little disruption, and claims will be paid. Other activities conducted by the Centers for Medicare and Medicaid Services (CMS), including health care fraud and abuse control and the Center for Medicare and Medicaid Innovation will also continue.
    • Billing Questions May Be Delayed. HHS employees, who answer Medicare billing questions and process enrollment applications, among others, are paid through annual appropriations and would be affected by the shutdown. Any closure that lasted weeks or longer could, therefore, disrupt the programs as fewer federal employees would be available to administer them.
    • Medicare Administrative Contractors will continue to perform all functions related to Medicare fee-for-service claims processing and payment.
  • Medicaid and the Children’s Health Insurance Program (CHIP) will continue to receive funding at the state level.
  • The National Institutes of Health (NIH) will continue patient care for current patients and have minimal support for ongoing research protocols.
  • The Food and Drug Administration (FDA) will continue limited activities related to its user fee funded programs such as reviews of new drugs and devices, as well as select vital activities.
  • The Indian Health Service will continue providing direct clinical health care services and referrals.

Activities That Will Not Continue Under the Government Shutdown:

  • CMS will not continue discretionary funding for health care fraud and abuse strike force teams, and fewer recertification and initial surveys for Medicare and Medicaid providers will be completed.
  • FDA will be unable to support most of its food safety, nutrition and cosmetics activities.
  • NIH will not admit new patients, unless deemed medically necessary by the NIH Director, nor initiate new protocols, nor will it take any actions on grant applications or awards.
  • CDC will be unable to support the annual seasonal influenza program.
  • The Health Resources and Services Administration will be unable to make payments under the Children’s Hospital GME Program and Vaccine Injury Compensation Claims.

CAP will continue to monitor these changes as updates become available and will continue to keep our members updated and informed.


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