By Kelly Parker, Vice President of External Affairs and Government Relations, Propelus
Welcome to our September Government Relations Update! This month, the healthcare landscape is facing a series of critical deadlines and new data. We’re tracking a looming federal budget deadline that could end key Medicare telehealth flexibilities, new legislation aimed at addressing workforce shortages, and a sobering new survey on healthcare worker burnout. Read on for a breakdown of these major developments and what they mean for the industry.
Medicare Telehealth Flexibilities Threatened by Budget Deadline, Federal Shutdown Possible
A looming September 30, 2025 deadline tied to federal budget negotiations threatens to roll back key Medicare telehealth flexibilities enacted during the COVID-19 Public Health Emergency. Without Congressional action, many of these provisions—critical for remote care access—will expire, creating uncertainty for healthcare providers and patients alike. If Congress doesn’t act, the rollback could cause major problems for both patients and healthcare providers, including but not limited to disrupted care and scheduling.
Therefore, this is more than just a policy issue—it’s about funding. Without new budget approval, these popular telehealth options could disappear, leaving providers scrambling and patients with fewer care options.
Congress is working on a continuing resolution (CR) to extend funding beyond the September 30 deadline. While the House has passed its version, the Senate has yet to advance the measure. Democrats have proposed their own version, which includes demands that often clash with Republican priorities for reduced spending and restrictions on funding related to the ACA and immigration programs—such as eliminating border wall funding. These disagreements have complicated efforts to reach a budget agreement. With the fiscal year ending September 30 and upcoming congressional recesses and holidays, the timeline is tightening.
If a budget is not passed, the consequences will extend beyond telehealth, potentially leading to a federal government shutdown. The most recent shutdown caused by a budget impasse occurred from December 22, 2018, to January 25, 2019. Lasting 35 days, it remains the longest shutdown in U.S. history.
Healthcare Workforce Resilience Act (HWRA) Reintroduced: Expanding Opportunities for IMGs and Foreign-Trained Nurses
On September 10, 2025, a bipartisan group of lawmakers reintroduced the Healthcare Workforce Resilience Act (H.R. 5283 / S. 2759), aimed at addressing critical physician and nursing shortages across the United States. The bill seeks to “recapture” approximately 15,000 unused immigrant visas for physicians and 25,000 unused visas for nurses that were authorized but never issued between 1992 and 2024. These visas would be gradually reallocated over a three-year period.
If enacted, the HWRA could play a vital role in alleviating healthcare workforce shortages, particularly in underserved and rural communities, while also impacting opportunities for international medical graduates (IMGs) and foreign-trained nurses.
Originally introduced in the 118th Congress as H.R. 6205, the bill garnered broad support but did not advance through the legislative process at that time.
The American Medical Association, the American Academy of Family Physicians, and numerous other national organizations endorse this initiative as a strategic response to the ongoing challenges in healthcare staffing.
Survey Reveals: Over Half of U.S. Healthcare Workers Plan to Switch Jobs by 2026
A recent Harris Poll, conducted in partnership with Strategic Education and surveying 1,504 frontline healthcare workers and 304 employers between June 26 and July 21, revealed that 55% of U.S. healthcare employees plan to change jobs within the next year. This trend is largely driven by burnout, feelings of underappreciation, and limited career advancement opportunities. The survey also found that 84% of healthcare professionals feel undervalued, while only 20% believe they have access to meaningful growth. These factors are intensifying concerns about staffing shortages and retention challenges across hospitals nationwide.
State Activity
California AB 876 Certified Registered Nurse Anesthetists (CRNAs)
As reported last month in our update, during the final weeks of the California legislative session, the legislature considered and passed AB 876. This legislation affirms and clarifies that Certified Registered Nurse Anesthetists (CRNAs) are authorized to administer anesthesia independently when ordered by a physician or dentist, without requiring prescribing authority or additional supervision. The bill was sent to the Governor’s desk for signature on September 11, 2025.
Governor Newsom has 12 calendar days to act on the bill. In California, this timeframe includes weekends and holidays, and if the 12th day falls on a weekend or holiday, the deadline is extended to the next business day. If the governor neither signs nor vetoes the bill within this period, it automatically becomes law.
California AB 1018 Automated Decisions Safety Act
AB 1018, which would have required companies and government agencies to notify individuals when automated decision systems were used for “consequential decisions” such as those related to employment or health care, failed to advance in the State Assembly during the final hours of the 2025 legislative session.
New Jersey A 5948 - Still pending
New Jersey A5948 expands the scope of practice for licensed acupuncturists, authorizing them to perform X-rays, electrodiagnostic tests, and other diagnostics. It also allows them to administer injections, IV therapies, and prescribe and dispense nutritional supplements. The New Jersey legislative session concludes in the first week of January 2026. With a gubernatorial race and elections for all 80 General Assembly seats occurring simultaneously, legislative progress may slow due to the election cycle.
Operation Nightingale Continues - Fraudulent Nursing Degrees
The U.S. Department of Justice (DOJ) announced that Operation Nightingale has entered its second phase. This ongoing sting operation, which resulted in 30 criminal convictions in 2023, has now led to the arrest and charging of 12 new defendants. All of the recent indictments and arrests were made in Florida.
Council on Licensure Enforcement and Regulation Annual Education Conference
At the Annual Meeting of U.S. and international regulators in Chicago, attendees were recognized for their resilience in navigating evolving licensing standards and technological advancements. Key priorities emerged throughout the discussions, including advancing international alignment and credential standardization to address workforce shortages; exploring the role of AI in regulatory processes and service delivery; streamlining or removing regulatory barriers to ease entry into practice; and reinforcing support for the mental health and well-being of the healthcare workforce.
Look out for our next update as we continue to track these and other important developments.