COVID-19 vaccination of staff now a condition of participation in Medicare and Medicaid, CMS announces

Many health systems already have required staff to be vaccinated, a policy endorsed by the American Hospital Association.

In a major expansion of COVID-19 vaccine requirements, the Biden administration announced Thursday, Sept. 9 that all staff working at Medicare- and Medicaid-certified facilities must receive the vaccine.

The requirement was implemented for staff at skilled nursing facilities last month and now will be expanded to hospitals, dialysis facilities, ambulatory surgical settings and home health agencies as a condition of participation in Medicare and Medicaid.

“Healthcare workers employed in these facilities who are not currently vaccinated are urged to begin the process immediately,” a news release states. “Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.”

The exact timing of the requirement was not announced Thursday. According to the news release, an interim final rule with comment period will be issued in October. In regulations that are being implemented across industries for employers with more than 100 workers, paid time off must be provided for employees to get the vaccine and recover from side effects.

The stated rationale behind the requirement

President Joe Biden announced the requirement as part of a broader effort to turn the tide against the pandemic. Other aspects of the plan require all federal employees and contractors to be vaccinated and private-sector employers with more than 100 employees to mandate vaccination or weekly testing of their workers.

“There is no question that staff, across any healthcare setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” Xavier Becerra, secretary of the U.S. Department of Health and Human Services, said in the news release. “Ensuring safety and access to all patients, regardless of their entry point into the healthcare system, is essential.”

The release cites data showing that nursing homes experience higher rates of preventable COVID-19 infection if fewer than 75% of staff are vaccinated. And vaccination rates appear to be lower than that at hospitals and end-stage renal disease facilities, based on CMS’s figures.

“We know that those working in healthcare want to do what is best for their patients in order to keep them safe,” stated CMS Administrator Chiquita Brooks-LaSure. “As the delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine. Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care.”

Many health systems already have required vaccination or announced plans to do so once the vaccines received full FDA approval, which happened for the Pfizer/BioNTech vaccine late last month. In early August, CNN reported that 1,500 systems were mandating vaccination.

The American Hospital Association issued a statement in July in which Rick Pollack, president and CEO, affirmed the organization’s support for “hospitals and health systems that choose, based on local factors, to mandate COVID-19 vaccines for their workforce. Doing so will help protect the health and well-being of healthcare personnel and the patients and communities they proudly serve.”