White House Signals End to Vaccine Mandates; HHS to Begin Sunsetting Health Care Worker Requirements

The Biden administration has announced an end to COVID-19 vaccination requirements for federal workers and other groups, as the U.S. Department of Health and Human Services (HHS) begins the process of doing the same for the workers of Medicare-certified health care providers.

In 2021, HHS and the U.S. Centers for Medicare & Medicaid Services (CMS) issued emergency regulations requiring COVID-19 vaccination for eligible staff at health care organizations that participate in Medicare or Medicaid, including hospice organizations. The mandate stipulated that all health care personnel who enter a care setting or come into contact with patients, families or caregivers must be vaccinated.

Vaccination rules are now lifting for federal employees and international travelers, while final guidance for health care workers is next in line, according to the White House.


“Today, we are announcing that the Administration will end the COVID-19 vaccine requirements for federal employees, federal contractors, and international air travelers at the end of the day on May 11, the same day that the COVID-19 public health emergency ends,” the administration said in a statement. “Additionally, HHS announced today that they will start the process to end their vaccination requirements for head start educators, CMS-certified health care facilities, and certain noncitizens at the land border.”

CMS indicated in a recent memo that the agency will share more details around vaccination requirements for health care providers in coming days, as the PHE’s end draws near.

For now, it’s important that hospices and other health care providers stay abreast on their local vaccination requirements, according to CMS.


“On May 11, 2023, the COVID-19 public health emergency is expected to expire. In light of these developments and comments received on the interim final rule, CMS will soon end the requirement that covered providers and suppliers establish policies and procedures for staff vaccination,” the agency stated in the memo. “CMS will share more details regarding ending this requirement at the anticipated end of the public health emergency.”

Providers that didn’t comply with the vaccine mandate rules are subject to monetary penalties, potential denials of payment, or, as a last resort, termination of their participation in Medicare or Medicaid.

Nearly 94% of health care personnel staff nationwide reported receiving at least one dose of a COVID-19 vaccine, or intended to do so soon, in a February 2023 Elsevier survey. About 88% of surveyed nurses, nurse practitioners and physician assistants indicated that they had been vaccinated. Those who didn’t most often cited lack of trust in the vaccines’ effectiveness.

Vaccine requirements have been a mixed bag for health care providers to navigate.

On one hand, vaccinations have helped minimize risk of the outbreak’s spread among staff and patients. On the other hand, the mandate pressed the ability to recruit and retain clinical staff during the pandemic.

Some stakeholders are pushing for the vaccine mandate to lift sooner rather than later.

“A continuation of the vaccine mandate is no longer needed. Our country is in a very different place now, as the public health emergency winds down, than in summer of 2021, when the mandate was initially proposed,” LeadingAge President and CEO Katie Smith Sloan said in a statement. “And, whether or not a mandate is in place, there is no question that COVID-19 vaccines are a safe and effective defense against the virus, which disproportionately impacts older adults and the people who care for them.”

The vaccine requirements are “another piece of the puzzle” that hospices must navigate through as the pandemic winds down, said Judi Lund Person, vice president of regulatory and compliance at the National Hospice and Palliative Care Organization (NHPCO).

It’s crucial that hospice providers continue to follow current rules tied to both COVID vaccines and screenings until regulators provide clarity, she stated.

“A lot of providers are asking about this, especially if they are in areas with low incidences of COVID,” Lund Person told Hospice News. “Does it mean they can relax COVID screenings for employees who are not fully vaccinated? That’s a question we don’t know the answer to yet. For new employees, it’s continuing to check their vaccination status. For the moment, when they’re surveyed, the surveyor will be looking at the vaccination record log of employees.”

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