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CMS, OSHA Issue New Vaccination Requirements

The Centers for Medicare & Medicaid Services (CMS) announced vaccination requirements for health care providers as a condition of participating in the Medicare and Medicaid programs.

Phase 1 of compliance requires that staff receive the first dose, or only dose as applicable, of a COVID-19 vaccine, or have requested or been granted an exemption, by Dec. 5. Phase 2 requires that the primary vaccination series has been completed by Jan. 4, 2022.

Hospitals are required to track and record the vaccination status of each staff member. Vaccine exemption requests and outcomes also must be documented. The Centers for Disease Control and Prevention provides an online staff vaccination tool.

If a provider does not meet the requirements, it will be cited as noncompliant by a CMS surveyor and have an opportunity to return to compliance before additional action occurs.

For more information, CMS issued FAQs. Additionally, stakeholders have 60 days to submit written comments to the agency on the regulation.

New OSHA Vaccination Standard

The Department of Labor’s Occupational Safety and Health Administration (OSHA) released an emergency temporary standard (ETS) for employers with at least 100 employees to promote widespread vaccination. OSHA earlier this year released an ETS for occupational exposure to COVID-19, on which America’s Essential Hospitals commented in August.

Under the new ETS, covered employers must develop, implement, and enforce a mandatory COVID-19 vaccination policy (with an exception for legally protected reasons, such as a medical condition or a sincerely held religious belief) or allow employees to undergo regular COVID-19 testing and wear a face covering at work in lieu of vaccination. An employee who is not fully vaccinated must be tested for COVID-19 at least weekly.

Employers must provide employees reasonable time, including up to four hours of paid time, to receive each primary vaccination dose, and reasonable time and paid sick leave to recover from side effects. The ETS does not require employers to pay for testing nor face coverings for those choosing to remain unvaccinated.

The requirements of the ETS do not apply to certain categories of employees, including those who do not report to a workplace where other individuals are present, those working from home, and those working exclusively outdoors.

Employers must comply with most provisions by 30 days after the date of publication in the Federal Register and within 60 days for the testing requirement for the unvaccinated.

OSHA has provided additional resources, including a fact sheet, a recorded webinar, and FAQs. Comments are due to the agency 30 days after publication in the Federal Register.

America’s Essential Hospitals is analyzing both the CMS and OSHA regulations and will send members a detailed Action Update in the coming days.

Contact Principal Policy Analyst Maryellen Guinan at or 202.585.0132 with questions.


About the Author

Maryellen Guinan is a principal policy analyst at America's Essential Hospitals.

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