Stay Motivated to Slim -What HHS layoffs mean for patients and access to recovery care | uxa2.com

November 20
2025

What HHS layoffs mean for patients and access to recovery care

By Susan Lofton, Vice President of Outcomes and Clinical Translation, WebPT.

weight: 400;”>this weight: 400;”>recent layoffsweight: 400;”> This initiative by the U.S. Department of Health and Human Services (HHS) has profound implications not only for policymakers and service providers, but also for patients who rely on rehabilitative treatment services.

weight: 400;”>With HHS staff reduced by 25%, critical functions that support patient access, program funding and policy guidance are under pressure.

weight: 400;”>As the Centers for Medicare and Medicaid Services (CMS) cuts 300 positions, the agency faces a reduction in its ability to provide operational support. This impacts implementation guidance, billing and coverage clarification, and issue resolution. When the new rules take effect, fewer staff will be available to answer therapists’ questions, causing delays that directly impact patient access and timely care.

Impact on patient access and services

weight: 400;”>Changes in the workforce have several potential impacts on patients receiving rehabilitation services:

Telehealth visits after September 2025

weight: 400;”>The Medicare telemedicine exemption that allows rehabilitation therapists to provide services remotely expired on September 30, 2025. Without further legislative action, PTs, OTs, and SLPs will not be able to receive Medicare reimbursement for telehealth services billed after this date.

weight: 400;”>This is especially important for homebound patients and those in rural areas who rely on teletherapy services. The uncertainty surrounding telemedicine creates significant planning challenges for practices that incorporate telemedicine into their service models and for patients who rely on remote access for care.

Service delivery and patient access

weight: 400;”>Healthcare organizations face challenges in delivering services when policy guidance is delayed or unclear, and when administrative processes take longer due to reduced staffing. That could lead to longer wait times for appointments, delays in starting treatment, and uncertainty about trying to push new policies with less federal support available to answer questions.

Research and future innovation

weight: 400;”>Changes in research funding and regulation at the National Institutes of Health (NIH) may affect the timeline for translating new research findings into clinical practice. Although research will continue, reduced ability to manage research projects may slow the development and dissemination of new rehabilitation technologies and evidence-based practices that ultimately benefit patients.

Impact on specific groups of people

weight: 400;”>Jill Jacobs, executive director of the National Association of Councils on Developmental Disabilities, commented on the changes to the Administration for Community Living: “People with disabilities are at risk. This is not just a matter of moving money. They are eliminating a federal agency that serves and is relevant to people with disabilities and seniors.”

weight: 400;”>Patients from low-income backgrounds, those with rare diseases, or those in rural areas often rely more on federally supported programs. The Administration for Community Living specializes in serving seniors and people with disabilities, a population that frequently requires PT, OT, and SLP services.

Quality supervision

weight: 400;”>The reduction in the size of the HHS workforce means a reduction in the ability to oversee activities. This includes monitoring Medicare Advantage plans, which have become the primary Medicare choice for many beneficiaries. “Service standards for Medicare Advantage beneficiaries and Affordable Care Act consumers will suffer due to fewer staff handling cases and less oversight of Medicare Advantage plans,” Government Executive quoted a senior CMS official as saying.

What should a rehabilitation therapist do?

weight: 400;”>In light of these changes, there are several practical steps therapists can take:

1. weight: 400;” aria-level=”1″>Stay informed:weight: 400;”> Monitor updates through professional organizations (American Physical Therapy Association (APTA), American Occupational Therapy Association (AOTA), and American Speech-Language-Hearing Association (ASHA)). These organizations track policy developments and provide guidance to their members.
2. weight: 400;” aria-level=”1″>Financial Plan:weight: 400;”> The 2026 final rule is expected to be released in November, and practices should prepare for the potential scenario. Reductions in CMS staffing may impact the timing of the final rule and the availability of implementation guidance. Plan conservatively until the final rule clarifies actual reimbursement rates. Consider payer mix strategies that reduce reliance on any single payment source.
3. weight: 400;” aria-level=”1″>Document thoroughly:weight: 400;”> Maintain complete documentation. With federal staffing reduced and policy clarification likely to be delayed, clear records will become increasingly important for managing audits and payment disputes.
4. weight: 400;” aria-level=”1″>promote:weight: 400;”> Contact your congressional representatives to share how policy changes or delays may impact your practice and patients. This is especially urgent as the Sept. 30 deadline for telemedicine expires. Concrete examples and concrete data are most effective. Participating in future public comment periods on the proposed rule provides the opportunity to share your clinical perspectives and concerns about policy changes.
5. weight: 400;” aria-level=”1″>Continuing professional development:weight: 400;”> Even as research funding models may change, stay abreast of continuing education and evidence-based practice.

Looking to 2026 and beyond

weight: 400;”>There is controversy over whether these workforce reductions will achieve the efficiency targets set by the HSS, or whether they will harm service delivery. Public health experts note that maintaining current service levels with a significantly reduced workforce will be challenging; however, some proponents believe these changes may lead to a greater emphasis on chronic disease prevention, an area in which rehabilitation therapists play an important role through mobility training, functional rehabilitation, and prevention of secondary complications. Whether reduced federal staffing will support or hinder initiatives in this area remains to be determined.

bottom line

weight: 400;”>Workforce layoffs at the U.S. Department of Health and Human Services (HHS) represent a significant change in federal health care management. For rehabilitation therapists, this means navigating uncertainty about payment policies, adapting to potential delays in policy implementation and guidance, and managing possible changes in program funding. For patients, especially those who rely on federally funded programs or Medicare services, visit hours and service availability may be affected.