CMS is requiring Medicare and Medicaid healthcare staff to be fully vaccinated by January 4
CMS makes vaccinations among Medicare, Medicaid healthcare staff mandatory
November 15, 2021
by John R. Fischer, Senior Reporter
Staff at any healthcare facility participating in Medicare and Medicaid programs are required to be fully vaccinated by January 4.
The mandate was issued by CMS as part of an emergency regulation, and affects more than 17 million workers in hospitals and other healthcare settings across the U.S. It expands on a previous decision back in August that required staff within more than 15,000 Medicare and Medicaid-participating nursing homes to be vaccinated.
“[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," said CMS Administrator Chiquita Brooks-LaSure in a statement on November 4, when the mandate was issued.
Under the most recent requirements, healthcare facilities must implement a policy that ensures staff receive at least one vaccination dose before they can provide any treatment or perform other services in their job by December 5. All must be fully vaccinated by January 4. Acceptable forms of vaccination include either two doses of Pfizer or Moderna, or one dose of Johnson & Johnson, according to Becker’s Hospital Review.
Healthcare facilities must also have a similar process for exemptions, which are granted on the basis of recognized medical conditions and religious beliefs.
“These rules really were developed with a full system perspective, meaning that we understand patients receive care throughout their care journey in several settings, that healthcare workers really often work or change jobs throughout the healthcare system,” Jonathan Blum, principal deputy administrator and COO at CMS, told Becker’s Hospital Review.
The requirements are seen by CMS as base requirements, due to the fact that many healthcare facilities have already mandated that their employees be vaccinated. The U.S. Department of Veterans Affairs was the first federal agency and one of the largest healthcare systems in the country to mandate the vaccine for its frontline workers back in August. Ascension followed it, as did Mayo Clinic, which set a deadline for its employees to get COVID-19 shots by September 17. Like Mayo, some healthcare organizations have already seen their deadlines pass.
Prior to these mandates (and in some cases, still), organizations offered incentives to encourage employees to get vaccinated. Centura Health promised a $500 bonus to any employee at its 17 hospitals if they got vaccinated, including those who were vaccinated many months before. The aim was to protect frontline workers to ensure a sufficient number were available to help care for patients.
While meant to keep workers safe and deter transmission of the virus, the mandates and incentives generated some opposition. More than 170 Houston Methodist employees back in June were suspended without pay for refusing to get vaccinated. In response, 117 disgruntled employees filed a suit that claimed the hospital’s policy was compelling them to receive an “experimental mRNA gene modification injection” in violation of the Nuremberg Code, a collection of ethical principles issued after WWII in response to horrific revelations of Nazi medical experimentation.
The U.S. Equal Employment Opportunity Commission disagreed with this stance and broadly acknowledged the legality of such employment policies. “Federal EEO laws do not prevent an employer from requiring all employees physically entering the workplace to be vaccinated for COVID-19, so long as employers comply with the reasonable accommodation provisions of the ADA and Title VII of the Civil Rights Act of 1964 and other EEO considerations.”
CMS plans to use surveys and enforcement processes to ensure healthcare staff members comply with the regulations. While a last resort, those that do not comply risk losing their ability to bill Medicare and Medicaid, according to Blum. "We will not be shy to use all the tools we have, but termination from the program really is the last step and something we don't want to see happen. That said, we have multiple stages to the survey process, and providers going through that process who are out of compliance will have steps to come into compliance before we come to that termination step."
CMS has implemented a comment process that is now in effect for the policy.
The mandate was issued by CMS as part of an emergency regulation, and affects more than 17 million workers in hospitals and other healthcare settings across the U.S. It expands on a previous decision back in August that required staff within more than 15,000 Medicare and Medicaid-participating nursing homes to be vaccinated.
“[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," said CMS Administrator Chiquita Brooks-LaSure in a statement on November 4, when the mandate was issued.
Under the most recent requirements, healthcare facilities must implement a policy that ensures staff receive at least one vaccination dose before they can provide any treatment or perform other services in their job by December 5. All must be fully vaccinated by January 4. Acceptable forms of vaccination include either two doses of Pfizer or Moderna, or one dose of Johnson & Johnson, according to Becker’s Hospital Review.
Healthcare facilities must also have a similar process for exemptions, which are granted on the basis of recognized medical conditions and religious beliefs.
“These rules really were developed with a full system perspective, meaning that we understand patients receive care throughout their care journey in several settings, that healthcare workers really often work or change jobs throughout the healthcare system,” Jonathan Blum, principal deputy administrator and COO at CMS, told Becker’s Hospital Review.
The requirements are seen by CMS as base requirements, due to the fact that many healthcare facilities have already mandated that their employees be vaccinated. The U.S. Department of Veterans Affairs was the first federal agency and one of the largest healthcare systems in the country to mandate the vaccine for its frontline workers back in August. Ascension followed it, as did Mayo Clinic, which set a deadline for its employees to get COVID-19 shots by September 17. Like Mayo, some healthcare organizations have already seen their deadlines pass.
Prior to these mandates (and in some cases, still), organizations offered incentives to encourage employees to get vaccinated. Centura Health promised a $500 bonus to any employee at its 17 hospitals if they got vaccinated, including those who were vaccinated many months before. The aim was to protect frontline workers to ensure a sufficient number were available to help care for patients.
While meant to keep workers safe and deter transmission of the virus, the mandates and incentives generated some opposition. More than 170 Houston Methodist employees back in June were suspended without pay for refusing to get vaccinated. In response, 117 disgruntled employees filed a suit that claimed the hospital’s policy was compelling them to receive an “experimental mRNA gene modification injection” in violation of the Nuremberg Code, a collection of ethical principles issued after WWII in response to horrific revelations of Nazi medical experimentation.
The U.S. Equal Employment Opportunity Commission disagreed with this stance and broadly acknowledged the legality of such employment policies. “Federal EEO laws do not prevent an employer from requiring all employees physically entering the workplace to be vaccinated for COVID-19, so long as employers comply with the reasonable accommodation provisions of the ADA and Title VII of the Civil Rights Act of 1964 and other EEO considerations.”
CMS plans to use surveys and enforcement processes to ensure healthcare staff members comply with the regulations. While a last resort, those that do not comply risk losing their ability to bill Medicare and Medicaid, according to Blum. "We will not be shy to use all the tools we have, but termination from the program really is the last step and something we don't want to see happen. That said, we have multiple stages to the survey process, and providers going through that process who are out of compliance will have steps to come into compliance before we come to that termination step."
CMS has implemented a comment process that is now in effect for the policy.