Medicare Telehealth Access Limited by Government Shutdown, Impacting Rural Patients

Millions of Medicare patients are facing limited access to telehealth services as the ongoing government shutdown enters its sixth week, forcing some to delay or forgo critical care.

The suspension of Medicare payments for telehealth and in-home hospital care, which began on October 1st, is particularly impacting elderly and disabled individuals, especially those in rural areas like Humboldt County, California. Dr. John Aryanpur, neurosurgeon at St. Joseph Hospital and Chief Medical Officer for NorCal Providence Medical Group & Clinical Network, estimates telehealth accounted for “between 10 and 18 percent” of outpatient visits prior to the shutdown. He noted that patients are canceling or postponing time-sensitive appointments due to the financial uncertainty. This disruption comes as telehealth usage has surged in recent years, with a report from Brown University finding California had the highest rate of adoption, with 26 percent of Medicare beneficiaries utilizing remote healthcare in the first half of 2025.

While a Senate vote on Sunday signaled a potential end to the shutdown this week, full restoration of services hinges on Congressional approval of the Hospital Inpatient Services Modernization Act, which would extend telehealth coverage through 2030. Open Door Community Health Centers is attempting to navigate the situation by requiring patients to be physically present in a clinic while utilizing remote providers, allowing for potential reimbursement under rural exemption guidelines. “We always put patient care first,” said Tory Starr, CEO of Open Door, adding that they are prepared to advocate for retroactive payment if necessary. The Centers for Medicare & Medicaid Services (CMS) guidance stipulates that rural residents generally must be in a medical facility to qualify for telehealth services. You can find more information about telehealth coverage from CMS.

Providence St. Joseph Hospital is continuing to provide telehealth care while working to resolve reimbursement issues, but some patients are opting to delay care altogether due to potential out-of-pocket costs. Shannon Garcia, Providence Humboldt County Communications Manager, stated the organization remains “committed to reducing impacts to our patients and ensuring continuity of care.” Officials anticipate continued advocacy for the restoration of essential waivers supporting flexible care delivery.