CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced.

The announcement made via CMS yesterday said the Administration will require COVID-19 vaccination of staff in all Medicaid and Medicare-certified facilities by October. The emergency regulation, when it is released, will apply to hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among other sites of care, as a condition for participating in the programs.

Nursing home workers are already required by CMS to be vaccinated against COVID-19, per an August 2021 announcement.

The US experienced a rocky summer as many communities saw a resurgence of COVID-19 because of the highly contagious Delta variant. Heading into the fall, the number of positive cases reported each week and hospitalizations due to the virus are both increasing, according to the latest report from the Centers for Disease Control and Prevention (CDC).

Healthcare leaders within the Biden-Harris Administration anticipate the upcoming regulation to protect healthcare workers and their patients from the Delta variant.

“There is no higher priority for us than patient health and safety. As the Delta variant strengthens, the Biden-Harris Administration is committed to doing everything we can to keep patients, and those who care for them, safe,” HHS Secretary Xavier Becerra, said in the announcement.

“We know that those working in health care want to do what is best for their patients in order to keep them safe. As the Delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine,” added CMS Administrator Chiquita Brooks-LaSure.

Many healthcare organizations have already mandated that their employees get the COVID-19 vaccine, especially now that the Food and Drug Administration (FDA) has fully approved the mRNA-based vaccine from Pfizer and BioNTech.

The American Medical Association (AMA), along with dozens of other healthcare organizations, has already backed COVID-19 vaccine mandates in healthcare settings.

“It is critical that all people in the health care workforce get vaccinated against COVID-19 for the safety of our patients and our colleagues. With more than 300 million doses administered in the United States and nearly 4 billion doses administered worldwide, we know the vaccines are safe and highly effective at preventing severe illness and death from COVID-19.” Susan R. Bailey, MD, immediate past president of AMA, said in a July 2021 statement.

Just yesterday, over a dozen healthcare organizations in and around Washington DC also issued a joint statement making COVID-19 vaccination a condition for returning to work in their respective offices. The organizations included America’s Essential Hospitals and AMGA.

But hospitals have feared that requiring a jab—or two for the Pfizer-BioNTech vaccine—may create workforce challenges during an already strained time.

Reports have shown that hospital and health system leaders are worried that vaccine mandates will exacerbate staffing shortages—something many organizations have been struggling with since the start of the COVID-19 pandemic in 2020.

And their concerns with the mandates may be valid. Over 150 employees at Houston Methodist resigned or were fired this summer after the Texas-based health system become one of the first healthcare organizations to mandate COVID-19 vaccinations.

A study published last month by researchers at Northeastern, Harvard, Northwestern, and Rutgers found that 27 percent of staff in healthcare facilities are not vaccinated against COVID-19.

“In places where you have lots of healthcare workers who are not vaccinated and there haven’t been mandates, it’s going to be like lots of tightly-packed dominoes where you knock one over and it’s going to create these big waves of infections,” said study author and university distinguished professor of political science and computer sciences at Northeastern David Lazer.

CMS expects to release the interim final rule tying COVID-19 vaccine mandates to Medicaid and Medicare participation next month. Until then, the agency is urging healthcare facilities to prepare their workforces for the new rules.