CMS Issues COVID-19 Vaccine Mandate for Healthcare Workers

CMS has issued the interim final rule with comment period requiring all healthcare workers to get a COVID-19 vaccine. The rule mandates vaccinations of eligible staff at healthcare facilities participating in Medicare and Medicaid programs by January 4, 2022.

CMS said the emergency regulation will apply to approximately 76,000 providers and cover over 17 million healthcare workers across the US.

“Ensuring patient safety and protection from COVID-19 has been the focus of our efforts in combatting the pandemic and the constantly evolving challenges we’re seeing,” CMS Administrator Chiquita Brooks-LaSure said in an announcement earlier today. “Today’s action addresses the risk of unvaccinated health care staff to patient safety and provides stability and uniformity across the nation’s health care system to strengthen the health of people and the providers who care for them.”

CMS first told healthcare providers that it would tie COVID-19 vaccinations to Medicare and Medicaid Conditions of Participation back in September. The agency believes mandatory COVID-19 vaccinations will protect frontline workers fighting the virus while safeguarding their patients and patient families as the Delta variant continues to spread.

CMS has already required nursing home workers to get vaccinated against the virus and vaccination rates among those workers has increased by about nine percentage points—from 62 percent to 71 percent.

The latest emergency regulation aims to boost COVID-19 vaccination rates among the general healthcare worker population and create a more consistent standard within Medicare and Medicaid.

Facilities covered by the emergency regulation must create a policy by December 4, 2021, ensuring all eligible staff have received either the first dose of the two-dose COVID-19 vaccines from Pfizer and Moderna or the single dose of the one-dose COVID-19 vaccine from Johnson & Johnson prior to delivering care, treatment, or services.

As part of a facility’s compliance with the regulation, they must provide reasonable time and paid leave for employees to receive the vaccines and recover from side effects, according to the interim final rule.

Any facilities where employees deliver healthcare services or healthcare support services must abide by the emergency regulation. According to CMS, this includes, but is not limited to, ambulatory surgical centers, hospices, Programs of All-Inclusive Care for the Elderly (PACE), hospitals, long-term care facilities, clinics, and community mental health centers.

All staff must also be vaccinated by the January 4th deadline as long as they interact with other staff, patients, residents, clients, or PACE program participations in any locations. This includes administrative staff, facility leadership, volunteers, and housekeeping and food services. Although, staff who provide services 100 percent remotely will not have to get vaccinated per the emergency regulation.

Healthcare workers will be able to apply for an exemption from mandatory COVID-19 vaccinations based on “recognized medical conditions or religious beliefs, observations, or practices,” CMS stated. Facilities subject to compliance with the regulation must establish a similar process or plan for enabling exemptions in line with the federal government’s law.

Compliance with the regulation will be tracked using survey and enforcement processes. Healthcare facilities found not complying with the requirements by December 4th will be given a warning and a chance to comply. However, CMS stressed that its goal is to bring all healthcare providers into compliance, and it will not hesitate to utilize full enforcement authority to achieve that goal.

Healthcare leaders have worried that mandatory COVID-19 vaccinations would exacerbate staffing shortages. CMS acknowledged the concern in the interim final rule.

“We are aware of concerns about health care workers choosing to leave their jobs rather than be vaccinated,” the agency wrote. “While we understand that there might be a certain number of [healthcare] workers who choose to do so, there is insufficient evidence to quantify and compare adverse impacts on patient and resident care associated with temporary staffing losses due to mandates and absences due to quarantine for known COVID-19 exposures and illness.”

The Biden-Harris Administration has touted the success of vaccination mandates. The mandates have resulted in only a small percentage of workers leaving their jobs and this includes anecdotes from hospitals and health systems that have already mandated vaccinations.

Currently, about 41 percent of hospitals across the country have some sort of vaccination mandate, The Washington Post reports using data from the American Hospital Association (AHA).