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Does the CMS Interim Final Rule for mandatory vaccination apply to physician practices?

This regulation and the requirements within only apply to providers and suppliers regulated under the CMS Conditions of Participation (CoPs). The CMS rule does not apply to independent physician offices.

This Interim Final Rule as stated by the Federal Register CMS Interim Rule on Health Care Staff Vaccination applies only to the Medicare- and Medicaid-certified providers and suppliers listed in this registry and does not directly apply to other health care entities, such as physician offices, that are not regulated by CMS. Most states have separate licensing requirements for health care staff and health care providers that would be applicable to physician office staff and other staff in small health care entities that are not subject to vaccination requirements under this Interim Final Rule.

CMS clarified in their Interim Final Rule slide deck published here Omnibus COVID-19 Health Care Staff Vaccination: Interim Final Rule with Comment who is eligible and who is excluded:

Eligibility – Who is included?

Requirements apply to facilities regulated under the Medicare Conditions of Participation (CoPs)

This Includes:

  • Ambulatory Surgery Centers
  • Clinics, Rehabilitation Agencies, and Public Health
  • Home Infusion Therapy Suppliers
  • Hospices
  • Hospitals

Agencies as Providers of Outpatient Physical Therapy and • Intermediate Care Facilities for Individuals with

Speech-Language Pathology Services

  • Community Mental Health Centers
  • Comprehensive Outpatient Rehabilitation Facilities
  • Critical Access Hospitals
  • End-Stage Renal Disease Facilities
  • Home Health Agencies

Intellectual Disabilities

  • Long Term Care Facilities
  • Programs for All-Inclusive Care for the Elderly Organizations (PACE)
  • Psychiatric Residential Treatment Facilities
  • Rural Health Clinics/Federally Qualified Health Centers

So What? – If you are one of the above providers or suppliers, this regulation applies to you and you must abide by the requirements

Eligibility – Who is excluded?

The following provider and supplier types are not included in this requirement:

  • Religious Nonmedical Health Care Institutions (RNHCIs)
  • Organ Procurement Organizations
  • Portably X-Ray Suppliers

Additionally, the requirements do not apply to the following:

  • Assisted Living Facilities
  • Group Homes
  • Home and Community-based Services
  • Physician’s Offices

Key Fact to Remember: This regulation and the requirements within only apply to providers and suppliers regulated under the CMS Conditions of Participation (CoPs)

Even though independent physician offices are not covered under this rule, anyone who actually visits a facility who is covered, such as a physician and any staff that may accompany the physician to the hospital, would be required to be vaccinated unless they meet the Medical or Religious exemptions also covered in this document, Omnibus COVID-19 Health Care Staff Vaccination: Interim Final Rule with Comment. The responsibility for enforcement would fall on the covered institution (such as the hospital) and not the physician office. Potentially this could become part of the credentialing process by the facility for providers who go into a covered institution, such as the hospital setting, to provide patient services.

 

CMS responded when asked Why didn’t CMS include all health care settings:

A: CMS is using the authority established by Congress under the Social Security Act to regulate Medicare and Medicaid-certified health facilities. Sections 1102 and 1871 of the Social Security Act (the Act) grant the Secretary of Health and Human Services general authority to make and publish such rules and regulations, not inconsistent with the Act, as may be necessary to the efficient administration of the functions with which the Secretary is charged. Citations to the relevant statutory authorities for each specific type of provider and supplier are set out in the discussion of each provider- and supplier-specific provision of the regulation. This authority does not extend to certain facilities nor independent physicians/clinicians.

News & Knowledge
All Curi recommendations are based on current CDC criteria at the time of publication. CDC guidance for SARS-CoV-2 infection may, or may not, be adopted by state and local health departments to respond to rapidly changing local circumstances. Providers should always check with their local health department to see if the CDC’s guidance on any given topic has been modified (particularly if more restrictive) from the CDC’s recommended guidelines. Follow this link https://www.cdc.gov/publichealthgateway/healthdirectories/index.html for contact information to your state/local health department. If local recommendations vary from those of the CDC, and you are unsure what recommendations to follow, then it is safer to follow the more restrictive guidelines/recommendations.