Revised ICA Statement on Vaccine Mandates


Updated September 13 at 3:30 pm: CMS provided the following information on background regarding clarification on the mandate rule:

“This regulation does not directly apply to physician’s offices as these are not regulated under the provider-specific Medicare health and safety regulatory provisions, generally referred to as “Conditions of Participation.”

Given that Doctors of Chiropractic are ‘physicians’ in Medicare, this mandate as currently issued, will not apply to chiropractors in private practice. ICA will keep you posted if this changes.

Updated September 13 at 1:10 pm: Official Statement from CMS Spokesperson on background, “

On background and attributable to CMS spokesperson:

CMS anticipates that the staff vaccination requirement would apply to Medicare and Medicaid-certified provider and supplier types that comply with the Medicare health and safety regulatory provisions, known as the Conditions of Participation, which includes, but is not limited to, hospitals, dialysis facilities, ambulatory surgical centers, and home health agencies.”

September 10, 2021 (Falls Church, VA) Today US President Biden, issued a series of Executive Orders related to mandating federal employees and federal contractors to receive the COVID-19 vaccine without a testing opt out. This includes some Medicare and Medicare providers including Fee For Service Facilities. Please read the below Center for Medicare and Medicaid Services (CMS) press release and the list of covered facilities.

ICA has reached out to CMS, members of Congress, and our legal counsel on this matter and will provide updates as they become available. According to CMS they are developing an interim rulemaking that will be published in October. As we get more details, we will update this information.

Biden-Harris Administration to Expand Vaccination Requirements for Health Care Settings

Sep 09, 2021 

The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities to protect both them and patients from the virus and its more contagious Delta variant.  Facilities across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect.

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced today that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19. 

“There is no higher priority for us than patient health and safety. As the Delta variant strengthens, the Biden-Harris Administration is committed to doing everything we can to keep patients, and those who care for them, safe,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

Nursing homes with an overall staff vaccination rate of 75% or lower experience higher rates of preventable COVID infection. In CMS’s review of available data, the agency is seeing lower staff vaccination rates among hospital and End Stage Renal Disease (ESRD) facilities. To combat this issue, CMS is using its authority to establish vaccine requirements for all providers and suppliers that participate in the Medicare and Medicaid programs. Vaccinations have proven to reduce the risk of severe illness and death from COVID-19 and are effective against the Delta variant.  CMS will continue to work closely with all Medicare and Medicaid certified facilities to ensure these new requirements are met.

“We know that those working in health care want to do what is best for their patients in order to keep them safe,” said CMS Administrator Chiquita Brooks-LaSure.  “As the Delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine. Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care. Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from COVID-19.”

CMS is developing an Interim Final Rule with Comment Period that will be issued in October.  CMS expects certified Medicare and Medicaid facilities to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements.  Health care workers employed in these facilities who are not currently vaccinated are urged to begin the process immediately. Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.


All fee-for-service (FFS) facilities


Hospitals & inpatient facilities

Acute care, Critical Access Hospitals (CAHs), & Inpatient Rehabilitation Facilities (IRFs)

Outpatient facilities 

Ambulatory Surgical Centers (ASCs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Federally Qualified Health Centers (FQHCs), & Rural Health Clinics (RHCs)

Long-term care facilities & Skilled Nursing Facilities (SNFs)

Durable medical equipment suppliers (DMEs)

Home Health Agencies (HHAs)


Clinical labs

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