11 Practical -What HHS Layoffs Mean for Patients and Access to Rehabilitation Care | uxa2.com

Author: Susan Lofton, Director of Outcomes and Clinical Change at WebPT.

weight: 400;”>The weight: 400;”>recent layoffsweight: 400;”> The Department of Health and Human Services (HHS) has far-reaching implications, not only for policymakers and service providers, but also for patients who depend on rehabilitation therapy services.

weight: 400;”>As HHS cuts its workforce by 25%, critical functions that support patient access, program funding, and policy guidance are under pressure.

weight: 400;”>As 300 jobs have been eliminated from the Centers for Medicare & Medicaid Services (CMS), the agency’s capacity to provide operational support has been reduced. This affects the implementation instructions, the clarification of billing and coverage, and the resolution of problems. When the new rules go into effect, fewer staff will be available to answer therapists’ questions, causing delays that directly affect patient access and timely care.

Impact on patient access and services

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

Telehealth Access after September 2025

weight: 400;”>Medicare’s telehealth exemptions, which allow physical 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 that date.

weight: 400;”>This is especially important for patients at home and those in rural areas who need remote care services. The uncertainty surrounding telehealth creates significant planning challenges for offices that have incorporated telehealth into their service models and for patients who depend on remote access to care.

Service delivery and patient access

weight: 400;”>When policy guidance is delayed or unclear, and when administrative processes take longer due to staff reductions, healthcare facilities face challenges in delivering services. This can lead to longer wait times for appointments, delays in starting treatment, and uncertainty for practices trying to navigate new policies with less federal support to answer questions.

Research and future innovations

weight: 400;”>Changes in National Institutes of Health (NIH) research funding and oversight may affect the translation of new research findings into clinical practice. Even as research continues, reduced leadership capacity in research programs may slow the development and dissemination of new rehabilitation techniques and evidence-based practices that ultimately benefit patients.

Impact on specific populations

weight: 400;”>Jill Jacobs, 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 transfer of funding. They are taking away a federal agency that is meant for people with disabilities and the elderly.”

weight: 400;”>Patients with lower incomes, rare diseases, or people living in rural areas often rely more on federally subsidized programs. The Administration for Community Living specifically served older adults and people with disabilities—populations that often need PT, OT, and SLP services.

Quality control

weight: 400;”>A smaller HHS workforce reduces the capacity of oversight functions. This includes tracking Medicare Advantage plans, which have become the preferred Medicare option for many beneficiaries. According to a CMS executive official: “Medicare Advantage beneficiaries and Affordable Care Act consumers will suffer as the number of people handling their cases decreases and oversight of Medicare Advantage plans weakens.”

What rehabilitation therapists should do

weight: 400;”>Because of these changes, therapists can take several practical steps:

1. weight: 400;” aria-level=”1″>Stay up to date:weight: 400;”> Follow updates through professional associations – American Physical Therapy Association (APTA), American Occupational Therapy Association (AOTA) and American Speech-Language-Hearing Association (ASHA). These organizations monitor policy developments and provide guidance to their members.
2. weight: 400;” aria-level=”1″>Plan economically:weight: 400;”> The 2026 final rule is expected to be finalized in November, so practices should prepare for potential scenarios. CMS staff reductions may affect both the timing of the final rule and the availability of implementation guidance. Plan cautiously until the final rule clarifies the actual reimbursement rates. Consider hybrid payer strategies that reduce reliance on any single payment source.
3. weight: 400;” aria-level=”1″>Thoroughly document:weight: 400;”> Maintain thorough documentation. Due to federal staff reductions and possible delays in clarifying policies, clear information will become increasingly important in managing audits and payment disputes.
4. weight: 400;” aria-level=”1″>Advocate:weight: 400;”> Contact your congressional representatives and let them know how policy changes or delays will affect your practice and patients. The September 30 telehealth deadline is coming up, so this is especially urgent. Specific examples and concrete information are most effective. Participating in future public comment periods for the proposed rules will provide an opportunity to share your clinical perspective and concerns about the practice changes.
5. weight: 400;” aria-level=”1″>Continue professional development:weight: 400;”> Stay current with continuing education and evidence-based practices, even as research funding models may change.

Looking ahead to 2026 and beyond

weight: 400;”>There is debate as to whether these workforce reductions will achieve HSS’s stated efficiency goals or whether they will jeopardize service delivery. Public health experts have stated that maintaining the current service level with a significantly reduced workforce will be challenging; However, some advocates suggest the changes could increase chronic disease prevention, an area where rehabilitation therapists play an important role through mobility training, functional rehabilitation and prevention of secondary complications. It remains to be determined whether federal staff reductions will support or hinder initiatives in this area.

Bottom line

weight: 400;”>The HHS workforce reductions represent a significant shift in federal health care administration. For rehabilitation therapists, this means navigating the uncertainty of payment policy, adjusting to potential delays in policy implementation and steering, and managing potential changes in program funding. Patients, particularly those dependent on federally funded programs or Medicare services, may experience effects on the timing of access and availability of services.