Healthcare workers must be fully vaccinated by January 4

Photo: Courtney Hale/Getty Images

Healthcare staff members who work in facilities that take Medicare and Medicaid reimbursement will be required by the Biden Administration to get vaccinated against COVID-19. The Centers for Medicare and Medicaid Services issued the emergency regulation today through an interim final rule that follows up on President Biden’s promised vaccine mandate in September.

CMS will ensure compliance with these requirements through established survey and enforcement processes. If a provider or supplier does not meet the requirements, it will be cited by a surveyor as being noncompliant and have an opportunity to return to compliance before additional actions occur, CMS said. 

The requirements will apply to approximately 76,000 providers and cover over 17 million healthcare workers across the country. Facilities covered by this regulation must establish a policy ensuring that all eligible staff members have received the first dose of a two-dose COVID-19 vaccine, or a one-dose COVID-19 vaccine, by December 5, before they can provide any care, treatment or other services. 

All eligible staff must 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. 

The regulation provides for exemptions based on recognized medical conditions or religious beliefs, observances or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.

“CMS’s goal is to bring healthcare providers into compliance,” the agency said.  “However, the Agency will not hesitate to use its full enforcement authority to protect the health and safety of patients.”

The requirements apply to: ambulatory surgical centers, hospices, programs of all-inclusive care for the elderly, hospitals, long-term care facilities, psychiatric residential treatment facilities, intermediate care facilities for individuals with intellectual disabilities, home health agencies, comprehensive outpatient rehabilitation facilities, critical access hospitals, clinics for such services as outpatient physical therapy and speech-language pathology services, community mental health centers, home-infusion therapy suppliers, rural health clinics, federally qualified health centers, and end-stage renal disease facilities.


The goal is to protect those fighting the virus on the front lines while also delivering assurances to individuals and their families that they will be protected when seeking care, CMS said.

The prevalence of COVID-19, in particular the Delta variant, within healthcare settings increases the risk of unvaccinated staff contracting the virus and transmitting the virus to patients. When healthcare staff cannot work because of illness or exposure to COVID-19, the strain on the healthcare system becomes more severe and further limits patient access to safe and essential care, CMS said. 


Many hospitals and other care facilities already require vaccinations for their staff.

In August, in conjunction with the Centers for Disease Control and Prevention, CMS required staff vaccinations within the nation’s more than 15,000 Medicare and Medicaid-participating nursing homes.

Since the Administration’s announcement, nursing home staff vaccination rates have increased by approximately nine percentage points – from 62% to 71%, CMS said. 

“This increase is encouraging, and this regulation will help to ensure even greater improvement in the vaccination rate among healthcare workers,” CMS said.

In September, President Biden mandated shots for healthcare workers, and also for the private sector. Biden’s plan required all employers with 100-plus employees to ensure their workers were vaccinated, and required vaccines for all federal workers and for millions of contractors that do business with the federal government. 

CMS said at the time that it was developing an Interim Final Rule with Comment Period to be issued in October.


“Ensuring patient safety and protection from COVID-19 has been the focus of our efforts in combating the pandemic and the constantly evolving challenges we’re seeing,” said CMS Administrator Chiquita Brooks-LaSure.

“Today’s action addresses the risk of unvaccinated healthcare staff to patient safety and provides stability and uniformity across the nation’s healthcare system to strengthen the health of people and the providers who care for them.”

Twitter: @SusanJMorse
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