September 13, 2021

The Biden Administration announced September 9 it “will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities," and that this requirement would apply to “clinical staff, individuals providing services under arrangements, volunteers, and staff who are not involved in direct patient, resident, or client care.”

There is not enough information at this time to know whether this requirement will impact all physician practices that receive Medicare and Medicaid dollars. The administration, through CMS, will release more details as it implements the requirements through the regulatory process. APMA expects that CMS will issue an interim final rule with comment period in October. 

In the meantime, the following information may be helpful:

• Medicare and Medicaid-certified facilities will be required to vaccinate all staff.  Such facilities include:
• Acute Care, Critical Access Hospitals (CAHs), & Inpatient Rehabilitation Facilities (IRFs)
• Outpatient facilities: Ambulatory Surgical Centers (ASCs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Federally Qualified Health Centers (FQHCs), and Rural Health Clinics (RHCs)
• Long-term care facilities & Skilled Nursing Facilities (SNFs)
• Durable medical equipment suppliers (DMEs)
• Home Health Agencies (HHAs)
• Hospices
• Clinical labs
• Ambulances
• Health professionals and clinical practices are likely affected under this provision if they:
• Work or provide services under arrangements at one of the above-listed facilities, including as part of a provider-based department
• Operate a CLIA-certified lab
• Serve as a DME supplier
• Operate an ambulatory surgical center
• Additional health professional offices may be further affected due to fee-for-service payments through Medicare, but the specifics of that would need to better defined in the upcoming CMS rule.

As a separate component of President Biden’s COVID-19 Action Plan, the Department of Labor through the Occupational Safety and Health Administration (OSHA) has been tasked with issuing an Emergency Temporary Standard (ETS) to implement a requirement that all employers with 100 or more employees ensure their workforce is fully vaccinated or that unvaccinated workers produce a negative test result on at least a weekly basis. As such, clinical practices with 100 or more employees will likely be subject to this requirement. The OSHA ETS is expected to be released in the coming weeks.

APMA will keep members informed about these matters as the Biden Administration releases more details.