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New Federal Vaccination Policies Require Employers to Ensure Workers Are Fully Vaccinated Against COVID-19

Advocate Masthead

CMS imposing vaccination mandate on health care facilities participating in Medicare and Medicaid

Nov 19, 2021 (ACP) – The American College of Physicians supports new federal regulations requiring many employees -- including those at most health care facilities -- to be vaccinated against COVID-19.

“ACP strongly favors these rules, which reflect the College's policies regarding public health,” said Shari Erickson, ACP interim senior vice president for governmental affairs and public policy. “Vaccination is a crucial weapon in the war against the pandemic, and we applaud the nation's policymakers for setting these new expectations.”

On Nov. 4, the White House announced two new vaccination mandates. In the most wide-ranging edict, the Occupational Safety and Health Administration will now mandate that all employers with 100 or more employees require workers to get vaccinated or undergo testing for COVID-19 at least weekly. Alternative testing options for those who refuse vaccinations will only be allowed at some workplaces.

Companies will be required to obtain proof of vaccine from employees and maintain records, Erickson said. Workers who choose the weekly testing option must wear face masks at the workplace regardless of any local laws.

In addition, she said, employers will have to provide paid leave for workers to get vaccinated and time off to recover from vaccinations. But the employers do not need to pay for testing for employees who choose that option.

ACP's policy on immunization of the public, approved by the Board of Regents in September 2021, states that ACP “supports immunization of the public according to the recommendations and standards established by the U.S. Advisory Committee on Immunization Practices, National Vaccine Advisory Committee, and the Centers for Disease Control and Prevention.”

ACP also called on states “to pass legislation to eliminate any existing exemptions, except for clear medical contraindications, from their immunization laws.”

In another new rule, the Centers for Medicare & Medicaid Services has imposed a vaccination mandate on health care facilities that participate in Medicare and Medicaid. No testing exemptions are allowed. These facilities include hospitals, ambulatory surgery centers and long-term care facilities. Home-health services are also included.

According to the White House, the rule applies to more than 17 million workers at approximately 76,000 health care facilities, including hospitals and long-term care facilities. “The rule is pretty broad,” Erickson said. “It applies not only to clinical staff but also nonclinical staff -- employees, students, volunteers, trainees. Everyone except for patients and visitors.”

Physician practices, unless they are part of a larger system, are exempt from the CMS regulation, as they are not subject to CMS health and safety regulations. However, ACP still recommends that they require vaccination in line with ACP policy.

ACP policy approved by the Board of Regents in September 2021 states that all health care workers should be immunized “unless there is a clear medical contraindication or other exemption under applicable employment law.”

Lawsuits are already challenging the federal vaccine mandates. “ACP will be watching as this plays out in the courts and continue to advocate for the new policies,” Erickson said. “We may need to engage in the court system to support the continuation of these policies.”

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Back to the November 19, 2021 issue of ACP Advocate