What Employers Should Know About OSHA and CMS Rules for Vaccination in the Workplace

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On November 4, 2021, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule that will require COVID-19 vaccinations for workers in almost all health care settings.*

Shortly after, the Occupational Safety and Health Administration (OSHA) also issued an emergency temporary standard (ETS), that will require companies with 100 or more employees to be fully vaccinated unless they qualify for an exemption.

The CMS interim final rule and the OSHA ETS both require workers to be fully vaccinated by January 4, 2022. Below are the key details to know about each as you prepare for that deadline.

CMS Rule Summary

  • The CMS rule requires all staff within a Medicare and Medicaid certified facility* to be vaccinated against COVID-19.
  • Under the rule, employers must have a process or plan in place for vaccinating staff, providing exemptions and accommodations, and tracking and documenting staff vaccinations within 30 days (December 5, 2021).
  • The process or plan for vaccinating staff must ensure that all eligible staff receive their first dose by December 5, 2021.
  • Also, under this rule, all eligible staff must receive all shots for full vaccination by January 4, 2022.

Click here to read the full press release and the FAQs from CMS.

OSHA’s Emergency Temporary Standard (ETS) Summary

  • The Emergency Temporary Standard (ETS) rule applies to employers with 100 or more employees.
  • ETS mandates that qualifying employers require COVID-19 vaccines or weekly testing for employees.
  • The ETS is effective immediately upon publication in the federal register.
  • Within 60 days, in order to comply with ETS, employers must make sure that:

(1) All requirements other than testing for employees who have not completed their entire primary vaccination dose(s) are met 30 days after publication, and

(2) Testing for employees who have not received all doses required for a primary vaccination 60 days after publication.

Ongoing ETS Updates as of November 8, 2021

On Saturday, November 6, the U.S. Court of Appeals for the Fifth Circuit, in response to a lawsuit filed on Friday, November 5 by various plaintiffs including the Attorney General of Louisiana, issued an order temporarily blocking the OSHA ETS.

A number of parties, including several businesses, advocacy groups, and the states of Texas, Louisiana, Mississippi, South Carolina, and Utah filed the motion for a permanent injunction. Citing “grave statutory and constitutional issues,” the court ordered the government stay enforcement of the ETS pending expedited judicial review.

Solicitor of Labor Seema Nanda said the U.S. Department of Labor is “confident in its legal authority” to issue the rule, stating that the Occupational Safety and Health Act of 1970 “explicitly gives OSHA the authority to act quickly in an emergency” and the Department is “fully prepared to defend [the ETS] in court.”

The Fifth Circuit provided the Federal government until 5:00 p.m. on Monday, November 8, 2021, to respond to the lawsuit’s request for a permanent injunction.

Additional ETS Resources

Despite the ongoing disputes over OSHA’s ETS, which could take some time to resolve in courts, it is essential that employers not wait until a resolution to determine which rule applies to their organization and formulate a plan. Below are various resources to learn more.

Medic Management Group will continue to provide updates and resources as they’re available. If you have any questions in the meantime, please reach out to Tamiya Williams at twilliams@medicmgmt.com or Ronnen Isakov at risakov@medicmgmt.com.

Tamiya is a Senior Manager with Medic Management Group, LLC.  focused on providing operational and administrative support to independent and hospital employed medical practices and health systems. Tamiya holds a Masters Degree in Healthcare Administration and is a Certified Practice Management Executive as validated by MGMA.

Ronnen Isakov is Managing Director Advisory Service with Medic Management Group. His background includes extensive work in areas including business advisory, valuation, network optimization, transaction support, and project management.

*CMS rule Includes Ambulatory Surgery Centers, Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, End-Stage Renal Disease Facilities, Home Health Agencies, Home Infusion Therapy Suppliers, Hospices, Hospitals, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services, Psychiatric Residential Treatment Facilities (PRTFs), Programs for All-Inclusive Care for the Elderly Organizations (PACE), Rural Health Clinics/Federally Qualified Health Centers, and Long Term Care Facilities.

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