CMS Vaccine Mandate

The Centers for Medicare and Medicaid Services (CMS) released details about the federal vaccine mandate for health care facilities. Read on to learn more about what this rule means for community health centers.
On November 4, 2021, the Centers for Medicare, and Medicaid Services (CMS) issued an Interim Final Rule with Comment Period (IFC) outlining how the federal COVID-19 vaccine requirement Medicare and Medicaid certified health care facilities, including Federally Qualified Health Centers (FQHCs), will be implemented. The rule was published following a September 2021, announcement by the Biden administration that the COVID-19 vaccine would be required in all Medicare and Medicaid certified facilities.
What is the timeline for implementation?
Implementation of the rule will occur in two phases:
  • By the end of Phase 1, ending on December 6, 2021, all staff must have received their first dose of Pfizer or Moderna vaccine or, received their only dose of the Johnson and Johnson vaccine. By this time, health centers must also have policies and procedures in place to implement the rule. 
  • By the end of Phase 2, ending on January 4, 2022, all staff must have received their second dose of the two-dose Pfizer or Moderna vaccines or their single dose of Johnson and Johnson vaccine. 
Which health center staff are affected?
The rule applies to employees regardless of whether their positions are clinical or non-clinical and includes employees, students, trainees, and volunteers - including board members. It also includes many contractors and other service providers. The requirement also applies to staff who work offsite in settings such as homes, clinics, and administrative offices. 
The only staff that are not subject to the requirement are staff who work 100% remotely and do not have contact with other staff members or patients. There is not an exception for staff to be regularly tested for COVID-19 rather than receive the vaccine. 
What exemptions are permitted?
Community health centers allow for exemptions for staff with recognized medical conditions for which vaccines are contraindicated- as a reasonable accommodation under the Americans with Disabilities Act. Health centers must also allow for exemptions for religious beliefs, observances, or practices- established under Title VII of the Civil Rights Act of 1964. 
How will the rule be enforced?
State Survey Agencies and Accrediting Organizations will be monitoring compliance with the rule. CMS will implement a series of tiered penalties for facilities, which could eventually lead to a facility no longer receiving reimbursement for Medicare and Medicaid.



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