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.

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