09/13/2021

Biden to Expand Vaccination Requirements for Some Health Care Settings

It Does Not Appear to Apply to Individual Practices, But Additional Clarification is Needed

On Thursday, September 9, 2021, President Biden held a press conference outlining new COVID-19 vaccination mandates nationwide. 

The announcement addressed three primary areas: all Executive Branch federal workers (most of the federal government workforce), companies with 100 or more employees, and facilities accepting payments from Medicare and Medicaid. The mandates for federal workers and 100+ employee companies do not appear to directly impact the vast majority of chiropractic physicians and their practices.

However, it is still unclear whether the COVID-19 vaccine mandates for Medicare and Medicaid facilities will impact chiropractic physicians because we are still awaiting further information about how "Medicare and Medicaid facilities" could be defined under federal rules.

At this time, the Centers for Medicare and Medicaid Services (CMS) has not released many specific details surrounding the Medicare announcement. The MAC has reviewed the announcement and can provide our members with the following  information as of today, based on the limited information available in the CMS press release:

• These new COVID-19 vaccine mandates are NOT in place yet. Each federal agency will have to issue Emergency Rules that will outline details. CMS has indicated that they are "developing an Interim Final Rule with Comment Period that will be issued in October." This means that we will not know the full intent of the mandate until at least October 2021 (possibly longer with a comment period), and, particularly, whether the mandate will in any way apply to chiropractic practices.
• The CMS press release indicates the new mandate will apply to "hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others." There was no further information about the term "among others."
• The CMS press release states that the vaccine mandate will apply to Medicare and Medicaid-certified "facilities," but it does not give a full definition of "facilities." The release only includes an online list of "facilities" here, and that list does not directly name providers rendering services in their offices.
• For potential context, Medicare traditionally separates facilities and non-facilities by naming hospitals as an example of a facility, and by referring to health care offices as examples of a non-facility.  See "How to Use the MPFS Look-Up Tool" page 12.
• However, some CMS definitions of "facilities serving Medicare and Medicaid beneficiaries" in the context of other regulations are broader and more non-specific.
• Until CMS releases more information, the MAC can only provide an analysis of the information currently available.

As a reminder, once CMS finalizes these rules, both state and federal rules must be considered, and the more restrictive rule or Executive Order would apply.

The MAC will continue to closely monitor these new federal mandates.  As more information is released, we will continue to provide information to our members.

Sources:
Biden Administration, “Path out of the Pandemic: President Biden’s COVID-19 Action Plan,” September 9, 2021
CMS Press Release, “Biden-Harris Administration to Expand Vaccination Requirements for Health Care Settings,” September 9, 2021