Health care providers and health care companies are required to work with federal regulatory agencies on a daily basis. As a result, many are wondering exactly how the government shutdown will impact their businesses. The Department of Health and Human Services (the "HHS") has published a plan outlining how it intends to cope with the shutdown (the "Plan"). The Plan identifies those services that will continue to be provided and those services HHS will have to shut down. In part, the Plan states:
Summary of Activities to Remain Open and to be Closed
Consistent with legal advice that activities authorized by law, including those that do not rely on annual appropriations, and activities that involve the safety of human life and protection of property are to be continued, some of the HHS activities that would continue include:
• Health Resources and Services Administration (HRSA) – HRSA would continue activities funded through sources other than annual appropriations including the Community Health Centers, National Health Service Corps, Maternal Infant, and Child Health Home Visiting program. Additionally, HRSA would continue the National Practitioner Databanks and Hansen's Disease Program.
• Administration for Community Living (ACL) – ACL would continue to support the Aging and Disability Resource Centers and Health Care Fraud and Abuse Control through mandatory appropriations.
• FDA - FDA would also continue select vital activities including maintaining critical consumer protection to handle emergencies, high-risk recalls, civil and criminal investigations, import entry review, and other critical public health issues.
• Centers for Medicare & Medicaid Services (CMS) – CMS would continue large portions of ACA activities, including coordination between Medicaid and the Marketplace, as well as insurance rate reviews, and assessment of a portion of insurance premiums that are used on medical services. In the short term, the Medicare Program will continue largely without disruption during a lapse in appropriations. Additionally, other non¬discretionary activities including Health Care Fraud and Abuse Control, Center for Medicare & Medicaid Innovation, and Pre-existing Condition Insurance Plan activities would continue. States will have funding for Medicaid on October 1, due to the advanced appropriation enacted in the FY 2013 appropriations legislation, as well as for the Children's Health Insurance Program (CHIP).
• Medicare Administrative Contractors (MAC) – MAC will continue to perform all functions related to Medicare fee-for-service claims processing and payment.
Activities that would not continue include:
• HRSA – HRSA would be unable make payments for the Children's Hospital GME Program and Vaccine Injury Compensation Claims. Monitoring of Ryan White Grants – particularly AIDS Drug Assistance Program Grants, Emergency Relief Grants and Comprehensive Care – would be insufficient to assure states, cities and communities are complying with statutory guidance and necessary performance.
• ACL – ACL would not be able to fund the Senior Nutrition programs, Native American Nutrition and Supportive Services, Prevention of Elder Abuse and Neglect, the Long-Term Care Ombudsman program, and Protection and Advocacy for persons with developmental disabilities.
• CMS – CMS would be unable to continue discretionary funding for health care fraud and abuse strike force teams resulting in the cessation of their operations. Fewer recertification and initial surveys for Medicare and Medicaid providers would be completed, putting beneficiaries at risk of quality of care deficiencies.
• FDA - FDA will be unable to support the majority of its food safety, nutrition, and cosmetics activities. FDA will also have to cease safety activities such as routine establishment inspections, some compliance and enforcement activities, monitoring of imports, notification programs (e.g., food contact substances, infant formula), and the majority of the laboratory research necessary to inform public health decision-making.
• ONC - ONC will be unable to continue the Standards and Interoperability Framework activities as well as related standards and testing activities; policy activities such as privacy, security, and clinical quality measure development; and administration of the Certified Health IT Product List.