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October 6, 2025

How the government shutdown affects you 

We’ve got your back on Capitol Hill—and we’re in overdrive advocating for you and your patients. Capitol Hill Report is your source for all things neurology advocacy, so keep reading and sharing to stay up to date. Plus, we want to hear from you: Let us know if your practice, research, or patients are affected by recent policy changes.  

You can make a difference! 

Congress needs to hear from you about the importance of reopening the government and extending telehealth for patients with neurological conditions. and make sure your voice is heard! 

Issue in focus

With Congress unable to reach an agreement on funding the government by the September 30 deadline, the federal government has entered a shutdown. This lack of agreement has also led to the expiration of telehealth flexibilities under Medicare, leaving you unable to be reimbursed for telehealth visits with certain Medicare patients until Congress fixes this issue. This will most likely impact you and your patients. Learn more.

Impact on telehealth
During the COVID-19 public health emergency, Congress enacted certain flexibilities allowing neurologists and other providers to see Medicare patients via telehealth. These flexibilities, including the lifting of geographic and site of service restrictions and allowing for audio-only visits, have been extended past the public health emergency multiple times by Congress. The most recent extension lasted through September 30, and Congress was unable to pass legislation to continue these flexibilities past that date—causing them to expire as of October 1.  

This means you are currently unable to be reimbursed for any visits provided through telehealth for most Medicare patients. In past shutdowns, whenever Congress passed legislation to reopen the government, it made funding and policies retroactive to the effective date of the shutdown. However, there is no guarantee that Congress will do this for telehealth—and there is no way to know how long the shutdown will last. Given this, neurology practices may want to consider adjusting their patient schedules for telehealth services.  

Impact on practice
Outside of telehealth, you will continue to be reimbursed for services provided through Medicare during the shutdown. The Centers for Medicare & Medicaid Services (CMS) has stated it will be able to continue making payments for Medicaid claims through the end of the first quarter of fiscal year 2026, which began on October 1, 2025. The agency has also indicated that it retains enough staff to process Children’s Health Insurance Program payments to eligible states.  

While reimbursements will continue, delays are possible if you need to dispute a claim or reach staff at CMS to discuss a claim.  

If you are employed by the Veterans Health Administration, you will continue to see patients and provide care as the VA is funded through advanced appropriations. Operations are also expected to continue at the National Institutes of Health’s Clinical Center. 

Impact on research
The National Institutes of Health (NIH) has only retained around 25% of its staff during the shutdown. Current grantees from the NIH can still use funds they have drawn down and should have the ability to draw down additional funds from their award. However, if an additional drawdown triggers a review, you may be unable to collect those funds in a timely manner due to staffing levels. Any new grant decisions will be delayed, as will the announcement of new grants.  

VA research will continue as long as advanced appropriations for that program last. If those funds are used up, then VA research staff will be furloughed.  

What can you do? 
While many congressional staff are also furloughed during a government shutdown, their offices stay open, and they need to hear from constituents about how the shutdown is impacting their state. While it only takes a minute, using the AAN’s Advocacy Action Center to contact your members of Congress can make a lifetime of difference for your patients. and make sure your voice is heard!

 
Latest advocacy news

AAN joins stakeholder letter on telehealth
In response to Congress allowing telehealth flexibilities to expire, the AAN joined members of the Alliance for Connected Care in urging congressional leadership to retroactively reinstate telehealth flexibilities as soon as possible.

Proposed physician visa changes would harm health care workforce 
The AAN, in partnership with the American Medical Association (AMA) and Physicians for American Healthcare Access (PAHA), led a coalition of over 40 organizations last week in signing a letter to the Department of Homeland Security (DHS) expressing deep concern about proposed changes to the J-1 physician visa program. The new rule would replace “duration of status” with fixed admission periods and recurring extensions, creating uncertainty and administrative burdens for international medical graduates (IMGs) who are vital to the US health care workforce—especially in rural and underserved communities. 

AAN joins advocacy efforts for HEADACHE Act
The Alliance for Headache Disorders Advocacy (AHDA) held its annual virtual Headache on the Hill fly-in last week. The AAN, serving on the AHDA board, participated in in-person Hill meetings to advocate for two key bills: the newly introduced HEADACHE Act (), led by Reps. Trahan (D-MA) and Fitzpatrick (R-PA), and the Safe Step Act (), led by Reps. Allen (R-GA) and McBath (D-GA). As the first standalone bill on migraine and headache disorders, the HEADACHE Act would establish a National Headache Disorders Initiative at HHS to address the medical, social, and economic impacts of headache disorders, expand the clinical and research workforce, and create an expert advisory council on headache disorders research, care, and services. This bill is modeled after the successful frameworks of the National Plan to End Parkinson's Act, signed into law last Congress, and the National Plan to Address Alzheimer's Disease. 

Organizations call for physician exemption from $100K visa fee
The AAN, along with over 50 medical specialty organizations, recently urged the DHS to make an exception for physicians from the recently announced $100,000 fee for H-1B visa applicants. The letter discusses the issues that this fee would cause for the health care workforce, which is highly dependent on H-1B physicians, particularly in rural areas.  

AAN pushes back on HHS autism claims
The AAN sent a letter to Secretary of Health and Human Services (HHS) Robert F. Kennedy, Jr., in response to recent announcements from the administration aimed at addressing autism spectrum disorders. The actions include discouraging the use of acetaminophen by pregnant women and updating the label for leucovorin to enable its use as a treatment for autism. The AAN’s letter pushed back on the evidentiary basis underlying the key claims made by HHS.   

What we're reading

• Medicare Advantage enrollment projected to fall in 2026: CMS ()

• Providers face $32.1B in lost 2026 revenue if enhanced ACA subsidies expire ()

• Will Cracking Down on Drug Ads Help Patients? (Op-Ed, )