The impact of the government shutdown on urology practices, with Scott B. Sellinger, MD

The ongoing government shutdown has placed a strain on physician practices nationwide, and urology groups are no exception. From halted policy work at the Centers for Medicare & Medicaid Services (CMS) to temporary disruptions in payments and coverage, the effects are being felt across both clinical operations and patient access.

Among the most immediate consequences for urologists is the rollback of key Medicare telehealth flexibilities, which expired at the start of the fiscal year in October. These changes have abruptly ended coverage for home and audio-only visits for most non-behavioral services, temporarily dismantling a tool many practices had come to rely on since the COVID-19 pandemic. For patients in rural or underserved areas who often travel long distances for specialty care, the loss of telehealth options is especially consequential.

Meanwhile, there is concern that staffing furloughs within CMS may slow progress on regulatory work, including the finalization of the 2026 Medicare Physician Fee Schedule. Without clarity on reimbursement and reporting rules, many practices may be left in limbo as they plan for the year ahead. The situation has fueled growing concern across the specialty that operational disruptions could soon translate into delays in care and worse outcomes for patients with chronic or complex urologic conditions.

To better understand the day-to-day impact of the shutdown on urology practices, Urology Times® spoke with Scott B. Sellinger, MD, FACS, a urologist at Advanced Urology Institute in Florida and the current president of LUGPA. Sellinger discussed the immediate financial and operational challenges facing urologists, the loss of telehealth flexibility, and why bipartisan action remains urgent.

Urology Times: There is concern that CMS may delay Medicare claims for up to 10 business days. Where does this stand now?

Sellinger: Initially, we felt that there could be significant impact, but very recently, we did get notification that CMS was going to release those payments going forward. So, at the present time, as we sit here today, it's likely that urology offices will be paid for claims after October 1. There should be no significant delays, but we were very much concerned about that as a possibility.

Urology Times: The expiration of Medicare’s telehealth flexibilities has eliminated coverage for home and audio-only visits for most non-behavioral services. How significant is this change for urology patients, especially those in rural or underserved areas?

Sellinger: The change with telehealth is huge for urology. During the public health emergency, during COVID-19, we were allowed to perform telehealth visits with our patients. We learned at that time how helpful this could be, especially for our patients who travel long distances and for patients who may not necessarily need to be seen in person. With the changes after October 1, we are no longer able to perform those services unless we perform them without being paid. For most practices, that's not an option. Most urology practices now have decided to terminate any telehealth services until further notice, and I know of some practices that have canceled upwards of 200 to 300 appointments in a month where they would have been seen by telehealth. Now, these patients either need to come to the office or have their appointments canceled altogether.

Urology Times: Do you anticipate that certain populations, such as older adults or some of those manage managing chronic urologic conditions might be disproportionately affected by these rollbacks?

Sellinger: Any patient who has a higher frequency of office visit needs could be affected more. We have many patients who just need to touch base with us periodically, just let us know that they're either doing okay, or that a medication may need to be adjusted, or they're having some [adverse events]. A lot of those problems can be easily handled by a telehealth visit. Now, we're going to be requiring those patients to come back in and travel long distances. In some cases, there could even be dangers associated with the travel, especially as we enter the winter season, where there can be icy or snowy roads. It's really a safety issue for some of these patients who are older and they may not be able to travel as well. We really look forward to the time when we can get past the shutdown and have an opportunity to resume telehealth.

I will tell you that, having just come back from Washington, DC in the past few days meeting with legislators, there's clearly bipartisan agreement that telehealth is good, that it's not being abused, and that we should be able to use telehealth in our practices. It's just a matter of getting it over the finish line in some end of the year package this year.

Urology Times: With CMS staff furloughs and policy work stalled, what are your concerns about delays in implementing the 2026 Physician Fee Schedule or other pending regulations?

Sellinger: That's really an unknown. We don't know what's going to happen with the Medicare Physician Fee Schedule. Typically, we get some final rule around the early part of November. There is some speculation, but no one's actually saying for sure, whether or not there will be a delay. There have been some furloughs and some changes in staffing at CMS that certainly could affect the time schedule for the fee schedules to be finalized.

Urology Times: How might some of these disruptions ultimately affect patient outcomes or timely access to treatment?

Sellinger: Anything that hampers our ability to treat our patients in a timely manner is problematic. We know when we need to see our patients, and we know what we need to do for our patients. When there are barriers where patients cannot be seen in a way that's safe for them to be seen, then that opens the door for complications and problems. We do expect some of that will occur, and that's why we hope and we impress upon our legislators that we need to get past this quickly.