- Hospitals and other healthcare facilities must mandate COVID-19 vaccination among employees or risk losing Medicare and Medicaid funding, CMS said Thursday. Employees must be fully vaccinated by Jan. 4.
- The rule came coupled with an order from the Occupational Safety and Health Administration requiring businesses with 100 or more employees to ensure workers are fully vaccinated, and those who aren't must be tested on a weekly basis by Jan. 4. Employers must also provide paid-time off for employees who need to get vaccinated.
- The CMS rule will affect about 17 million healthcare workers at 76,000 facilities, the agency said. Unlike the OSHA requirement, healthcare employees will not be able to forego the vaccine and be tested regularly.
The rules that dropped Thursday follow others rolled out in July requiring vaccinations for federal employees and contractors. As it stands today, 70% of American adults have received two doses of a coronavirus vaccine, according to a White House press release.
Hospitals, ambulatory surgery centers, dialysis facilities, home health agencies and long-term care facilities that receive federal funding from Medicare or Medicaid will have to ensure staff have received at least one dose before they can provide any care, treatment or services to patients by Dec. 5.
The rule applies to both clinical and non-clinical employees, including students, trainees, volunteers and people providing treatment or other services under contract or other arrangements.
"The prevalence of COVID-19, in particular the Delta variant, within health care settings increases the risk of unvaccinated staff contracting the virus and transmitting the virus to patients," CMS said in a release. "When health care staff cannot work because of illness or exposure to COVID-19, the strain on the health care system becomes more severe and further limits patient access to safe and essential care."
Both states and health systems have historically used vaccination requirements for other diseases, such as influenza and hepatitis B, according to a White House report.
And roughly 40% of all U.S. hospitals currently have COVID-19 vaccination requirements for their workforce.
Despite concerns around widespread resignations due to vaccine mandates, systems that implemented their own have fared positively, according to the report.
After UNC Health and Novant Health in North Carolina required the shots, staff vaccination rates rose to 97% and 99%, respectively, according to the report.
Among Novant Health's 35,000 employees, about 375 were suspended for not complying, and about 200 of those suspended employees did end up getting vaccinated so they could return to work, according to the report.
The new rules from both CMS and OSHA preempt any inconsistent state or local laws, including those banning or limiting an employer's authority to require vaccination, masks or testing, according to the White House release.
They also allow for exemptions for medical conditions or religious beliefs, though facilities must develop a plan for permitting exemptions in line with federal law.
Provider groups including the American Hospital Association, American Medical Association and American Nurses Association said in a Thursday statement that "the only way to truly end this pandemic is to ensure widespread vaccination and continue taking the preventive public health measures that we know work in curbing the spread of this virus." The statement did not directly address the mandate.
The rule did receive pushback. In a hearing Thursday morning on the country's COVID-19 response, Sen. Richard Burr, R-N.C., said the CMS mandate "will only suggest to doctors not to accept Medicare or Medicaid patients," although he did not offer evidence for the statement.