On Thursday, January 13, 2022, the Supreme Court of the United States issued its opinions in each of the Centers for Medicare and Medicaid Services (CMS) and Occupational Safety and Health Administration (OSHA) vaccination requirement cases in Biden v. Missouri and Nat’l Federation of Independent Business v. Dept. of Labor, permitting the federal vaccine mandate for nearly 10 million healthcare workers to go forward pending further review, but preventing OSHA’s enforcement of its vaccine or test mandate for workers of employers with 100 or more employees.
In Biden v. Missouri, the Court stayed the lower courts’ preliminary injunctions against CMS’s enforcement of its Interim Final Rule, implemented in November 2021. The rule created a new Condition of Participation (CoP) for certain Medicare and Medicaid-certified facilities, requiring that in order to continue to receive Medicare and Medicaid reimbursements under the new rule, facilities must ensure that 100% of their staff – unless exempt for medical or religious reasons – are vaccinated against COVID-19. The Supreme Court’s ruling removes the barrier of enforcement of the CMS vaccine mandate imposed by the preliminary injunctions against enforcement effected for 24 states (other than Texas), granted by the federal district courts for the Eastern District of Missouri and Western District of Louisiana, respectively, issued in late 2021, pending a final ruling in each of the lower court cases on appeal to the appellate courts for the Fifth and Eighth circuits. A separate case controlling the fate of the CMS vaccine mandate’s enforceability in Texas is still pending, and thus the mandate remains blocked in the State of Texas. CMS has, however, requested Judge Matthew Kacsmaryk of the U.S. District Court for the Northern District of Texas to similarly lift its preliminary injunction against enforcement of the mandate in Texas in light of the Biden v. Missouri decision. Thus, for now, the CMS vaccine mandate for healthcare employees will be allowed to proceed in adjusted scheduled phases, with all employees of facilities in the 24 states bound by the Supreme Court’s decision required to obtain their first COVID-19 vaccine dose by February 13, 2022. Employees of facilities in the other 25 states (except Texas) that did not challenge the CMS vaccine mandate must obtain their first COVID-19 vaccine dose by January 27, 2022, according to CMS’s originally scheduled phases under the Interim Final Rule.