Critical Data and Shutdowns

“Non-essential” services are healthcare data services upon which providers come to rely.

EDITOR’S NOTE: A second government shutdown remains a possibility if a group of bipartisan lawmakers fails to reach an agreement by Feb. 15 on a border security funding package that would avoid a veto from President Trump.

Here is a post from the Centers for Medicare & Medicaid Services (CMS) website during the recent partial government shutdown:

Powell3.jpg

What happens when the government shuts down? What happens when the government partially shuts down? There are long-term and short-term impacts. There are lingering impacts.

We just ended the longest shutdown in federal government history. Another deadline is looming.

During a temporary shutdown, “essential” government services continue while non-essential services are stopped. What are “essential” government services?

Essential services mean “services, by whomsoever rendered, and whether rendered to the Government or to any other person, the interruption of which would endanger the life, health, or personal safety of the whole or part of the population.”

There is a lot of interpretation to be had here. Social Security checks will go out. Medicare claims would almost certainly be paid, but could be deemed non-essential. Enrollment services are not usually deemed non-essential. If someone who qualifies for Medicare but can’t enroll during a shutdown and waits to go to the hospital and dies from lack of care, are enrollment services then considered “essential?” My personal view is that they are. 

You could argue under the Emergency Medical Treatment and Labor Act (EMTALA) that hospitals would have to provide care for this patient. Should people who qualify for Medicare but can’t enroll during a shutdown take the risk that Medicare will back-date their eligibility?

After a month of the government being shut down, my other question on lingering impacts is this: how long will it take for non-essential services take to catch up after a shutdown? Imagine if you stopped going to work for a month. What would the backlog on your desk look like?    

Business runs on data. Included in “non-essential” services are the healthcare data services upon which providers come to rely. Here is a partial list of healthcare data the federal government provides:

  • Hospital Compare datasets
  • Nursing Home Compare datasets
  • Renal Dialysis Compare datasets
  • Updates to the National Provider Identifier datasets
  • Part B provider data
  • Medicare Advantage enrollment data
  • Fee-for-service enrollment data
  • Patient Protection and Affordable Care Act enrollment data

In terms of lingering impacts, what is the impact on healthcare when providers and suppliers do not get updated data? It is very difficult to say.              

 

Comment on this article

Facebook
Twitter
LinkedIn

Timothy Powell, CPA, CHCP

Timothy Powell is a nationally recognized expert on regulatory matters, including the False Claims Act, Zone Program Integrity Contractor (ZPIC) audits, and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) compliance. He is a member of the RACmonitor editorial board and a national correspondent for Monitor Mondays.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering Breast Biopsy Billing: Guidance-Driven Coding for Accurate Reimbursement

Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.

May 21, 2026

Mastering OB GYN Coding Accuracy: Precision Coding for Compliance and Reimbursement

Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.

May 14, 2026

2026 ICD-10-CM/PCS Coding Clinic Update Webcast Series

Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.

April 13, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Fourth Quarter

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

December 14, 2026

Trending News

Featured Webcasts

Reengineering Utilization Management: Building an Adaptive Model for the New Payer Era

Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.

May 20, 2026

Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices

Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.

April 9, 2026

Mastering MDM for Accurate Professional Fee Coding

In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.

March 31, 2026

The PEPPER Returns – Risk and Opportunity at Your Fingertips

Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.

March 19, 2026

Trending News

Celebrate Lab Week with MedLearn! Sign up to win one year of our Laboratory All Access Pass! Click here to learn more →

Have a Medicare regulation question you’d love Dr. Hirsch to answer? Now is your chance! CLICK HERE to learn more→

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