Federal mandate: Health care workers must be vaccinated by Jan. 4
All providers and suppliers at health care facilities that receive Medicare and Medicaid funds must be vaccinated against COVID-19 by Jan. 4, 2022, under an interim final rule published this week by the Centers for Medicare and Medicaid Services (CMS). The mandate does not apply to physician offices and other health care entities not regulated by CMS. A similar interim final rule published by the Occupational Safety and Health Administration (OSHA) applies to employers with more than 100 workers.

According to a summary of the CMS interim final rule published in the Federal Register along with the text of the rule:

“This interim final rule with comment period revises the requirements that most Medicare- and Medicaid-certified providers and suppliers must meet to participate in the Medicare and Medicaid programs. These changes are necessary to help protect the health and safety of residents, clients, patients, PACE participants, and staff and reflect lessons learned to date as a result of the COVID-19 public health emergency. The revisions to the requirements establish COVID-19 vaccination requirements for staff at the included Medicare- and Medicaid-certified providers and suppliers.”

CMS has clarified that the interim final rule with comment period specifically regulates the providers and suppliers listed below along with their relevant Code of Federal Regulations (CFR) sections and “does not directly apply to other health care entities, such as physician offices, that are not regulated by CMS”:
  • Ambulatory Surgical Centers (ASCs) (Sec. 416.51)
  • Hospices (Sec. 418.60)
  • Psychiatric residential treatment facilities (PRTFs) (Sec. 441.151)
  • Programs of All-Inclusive Care for the Elderly (PACE) (Sec. 460.74)
  • Hospitals (acute care hospitals, psychiatric hospitals, hospital swing beds, long term care hospitals, children’s hospitals, transplant centers, cancer hospitals, and rehabilitation hospitals/inpatient rehabilitation facilities) (Sec. 482.42)
  • Long Term Care (LTC) Facilities, including Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), generally referred to as nursing homes (Sec. 483.80)
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) (Sec. 483.430)
  • Home Health Agencies (HHAs) (Sec. 484.70)
  • Comprehensive Outpatient Rehabilitation Facilities (CORFs) (Sec. 485.58 and Sec. 485.70)
  • Critical Access Hospitals (CAHs) (Sec. 485.640)
  • Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services (Sec. 485.725)
  • Community Mental Health Centers (CMHCs) (Sec. 485.904)
  • Home Infusion Therapy (HIT) suppliers (Sec. 486.525)
  • Rural Health Clinics (RHCs)/Federally Qualified Health Centers (FQHCs) (Sec. 491.8)
  • End-Stage Renal Disease (ESRD) Facilities (Sec. 494.30)

Also this week, OSHA issued an interim final rule that applies to businesses with more than 100 employees. The policy requires those large employers to either implement and enforce a mandatory COVID-19 vaccination policy by Jan. 4, 2022, or to require their employees to be tested regularly for COVID-19 and wear a face covering at work – also by Jan. 4.

Indiana Attorney General Todd Rokita has said that Indiana, along with several other states, plans to file legal challenges to both the CMS and OSHA mandates. ISMA will continue to keep members updated on any further developments.