CMS on Nov. 4 issued an emergency regulation that requires COVID-19 vaccination for all eligible staff at healthcare facilities participating in Medicare and Medicaid programs.
The requirements, which cover more than 17 million workers in hospitals and other healthcare settings nationwide, including about 76,000 providers, expand on the government's announcement Aug. 18 that staff within more than 15,000 Medicare and Medicaid-participating nursing homes must be vaccinated.
"We came to the full understanding we had to set these rules not just for one sector but for all healthcare sectors that CMS regulates," Jonathan Blum, principal deputy administrator and COO at CMS, said in an interview with Becker's Hospital Review. "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."
To comply with this regulation, healthcare facilities must establish a policy ensuring staff have received at least one vaccine dose prior to providing any treatment or other services by Dec. 6. Staff must be fully vaccinated with either two doses of Pfizer or Moderna's shot, or one dose of Johnson & Johnson's by Jan. 4.
The emergency regulation also requires healthcare facilities to implement a similar process for permitting exemptions based on recognized medical conditions and religious beliefs.
Many healthcare facilities have already announced mandates for their employees, and some have seen their mandate deadlines pass. That's why Mr. Blum said the requirements announced Nov. 4 should be thought of as base requirements.
"The way to think about it is they are the base requirements that all facilities have to meet that participate in the Medicare and Medicaid programs. But for those that have chosen to go sooner, for those that have gone beyond these rules, there's nothing that would prevent them from doing so," he told Becker's.
CMS said it will ensure compliance with these regulations through its established survey and enforcement processes.
While healthcare facilities that don't comply could risk termination from the Medicare and Medicaid programs, this would only happen as a last resort, according to Mr. 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," he said. "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."
Mr. Blum also said CMS has a comment process that's now in effect and wants to continue working with providers and consumer groups to ensure the rules promote safety.
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This story was updated on Nov. 11.