Health Care

Industry has questions, concerns about CMS vaccine mandate

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Industry stakeholders lauded the intent of COVID-19 vaccine rules released Thursday morning by the Centers for Medicare and Medicaid Services and the Occupational Safety and Health Administration, but many still have lingering concerns, particularly about whether the requirements will lead to more healthcare workers leaving an already tight labor market.

Meanwhile, Republican state officials immediately indicated they’re planning to sue the federal government over the OSHA rule, a move that’s been expected since the Biden administration announced it would require the two agencies to put out COVID-19 vaccine policies in September. The legal battle could begin as soon as Friday.

“Today’s vaccine mandate regulations set clear expectations, and streamline and simplify compliance requirements for healthcare providers. Importantly, they clarify that hospitals will need to comply with only the CMS rule, eliminating unnecessary complexity in implementing vaccine mandates,” Rick Pollack, president and CEO of the American Hospital Association, said in a news release. “Additionally, we welcome that the CMS regulation provides time to come into compliance, offers guidance on medical and religious exemptions, clarifies interactions with state and local laws, and provides a level playing field across healthcare facilities.”

Organizations will have until Jan. 4 to come into compliance with the rules. LeadingAge CEO and President Katie Smith Sloan said the organization appreciates that CMS is allowing facilities time to comply and offer medical and religious exemptions.

But like other stakeholders, LeadingAge still has concerns about how the policy will exacerbate workforce issues.

“The policy could further complicate staffing issues (including the prospect of additional departures) for our members who are already contending with longstanding workforce challenges exacerbated by the pandemic. We cannot overemphasize the need for staffing support and will continue to make our members’ needs known to the Administration and to CMS,” Smith Sloan said in a statement.

The American Health Care Association/National Center for Assisted Living is also still worried about healthcare workers leaving nursing homes as a result of the CMS vaccine mandate, and is concerned that CMS hasn’t discussed providing resources to providers for getting into compliance with the requirement.

“While we support the overall intent of this CMS policy, we are concerned that the execution will exacerbate an already dire workforce crisis in long term care. A hard deadline with no resources for providers or glide path for unvaccinated workers is likely to push too many out the door and ultimately, threaten residents’ access to long term care,” AHCA/NCAL CEO and President Mark Parkinson said in a statement.

However, some organizations believe the rule will help ease workforce shortages. The Society for Healthcare Epidemiology of America said it fully supports vaccine requirements for large organizations, especially healthcare providers.

“Vaccines are the most effective and scientifically supported way to protect patients, staff and visitors from the COVID-19 virus, and widespread vaccination in other large workplaces will protect the larger community as well,” Dr. Mary Hayden, president of the Society for Healthcare Epidemiology of America Board of Trustees, said in a news release. “Making sure that large organizations are required to have vaccinated staff helps level the playing field so facilities can hire and retain healthcare workers. It addresses the critical shortage of staff across the healthcare continuum.”

America’s Essential Hospitals applauded the rule but asked for guidance to be issued quickly.

“The interim final rule from the Centers for Medicare & Medicaid Services aligns with our commitment to vaccination as the best way to protect patients and keep caregivers safe. We appreciate the phased approach to compliance, and we ask the agency to release interpretive guidance as soon as possible to help providers comply with the new vaccine requirements,” AEH President and CEO Bruce Siegel said in a release.

Guidance is important to insurance stakeholders, too. The Alliance of Community Health Plans wants the federal government to clarify reimbursement responsibility for employees subjected to the OSHA rule who decide to get weekly COVID-19 tests instead of vaccines. This option is not available to healthcare employees that fall under the CMS rule.

“To protect the premium dollar of every consumer, it is essential that the Administration reassert that health plans are only responsible for health-related testing,” an October letter from ACHP, recirculated Thursday, says.

Concerns aside, health stakeholders continue to encourage vaccinations for everyone. The American Hospital Association, American Medical Association and American Nurses Association issued a joint statement encouraging widespread vaccination after the death toll from COVID-19 hit 750,000 Americans. The statement doesn’t mention the CMS or OSHA vaccine requirements.

“This devastating milestone should serve as a reminder to everyone that the COVID-19 pandemic is not over and still poses a major threat to our society, particularly to the unvaccinated,” the statement reads. “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.”


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