CMS Issues Vaccine Mandate Guidance for Surveyors and Providers in Some States

In roughly half the states in the US, the Medicare provider vaccine mandate/interim final rule is moving ahead as scheduled. Today we have a better idea of what compliance and enforcement will look like thanks to new guidance from CMS, QSO-22-07.

The interim final rule requires all eligible staff to have received the necessary shots to be fully vaccinated – either two doses of Pfizer or Moderna or one dose of Johnson & Johnson – by January 4, 2022. All eligible staff working at your facility must be vaccinated, regardless of clinical responsibility or patient contact. The interim final rule does not permit any alternate solutions such as regular testing. The only exceptions in the rule are those for religious objections and staff that are 100% remote. Your facility’s adherence to these standards will be monitored by state survey agencies.

Due to ongoing legal challenges, this guidance does not apply to the following states at this time: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia and Wyoming. Per CMS: Surveyors in these states should not undertake any efforts to implement or enforce the interim final rule.

CMS expects all providers’ and suppliers’ staff to have received the appropriate number of doses by the timeframes specified in the QSO-22-07 unless exempted as required by law, or delayed as recommended by CDC. Facility staff vaccination rates under 100% constitute noncompliance under the rule. Non-compliance does not necessarily lead to termination, and facilities will generally be given opportunities to return to compliance. The new guidance outlines procedures for state survey agencies to follow, with escalating severity every 30 days until 90 days of noncompliance is reached. Should a facility fail to comply after 90 days, serious enforcement action may be taken.

Click here to access both general and provider-specific guidance from CMS.