“Be prepared for anything.” That was the message the National Association for Home Care & Hospice and a prominent home care attorney delivered during a webinar Thursday about uncertainty over federal vaccine mandates and other legislation pending before Congress.
The home care industry is in a state of flux over two federal vaccine mandates that could wind their way to the U.S. Supreme Court. On Wednesday, a federal appeals court ruled that a lower court overreached when it blocked a vaccine mandate for healthcare workers in all 50 states. The vaccine mandate issued by Centers for Medicare and Medicaid Services is now in effect for 26 states but remains temporarily blocked in 24 states that challenged it in court.
Attorney Angelo Spinola told NAHC members to be prepared for the vaccine mandate to be reinstated in all states. The mandate requires that all healthcare workers at facilities receiving funding from CMS be fully vaccinated by Jan. 4.
“With all of the stopping and starting, it’s not clear what happens to a company that has unvaccinated staff by January 4th,” Spinola said. “I think you want to take a conservative approach if this CMS requirement applies to you and do everything you can do to get everyone vaccinated by that date …”
Spinola also advised firms with 100 or more employees to be prepared to comply with the Occupational Safety and Health Administration’s vaccine mandate. That requirement — also set to take effect Jan. 4 — has been paused nationally by legal challenges. However, Spinola cautioned the mandate could be reinstated later through further court action.
Additional in limbo is the Biden administration’s $2 trillion Build Back Better plan, which could funnel $150 billion to home-and-community-based services. NAHC President William Dombi said Build Back Better is in a “touch and go position at this point” because Senate Democrats still don’t have enough votes to pass the legislation before the end of the year.
“They need Sen. Joe Manchin’s (D-KY) vote and we need them to pass Build Back Better to bring that significant support to home-and-community-based services,” Dombi said.
Still, the news is not all bad, Dombi noted. The home care industry also has received some positive news from Washington of late. For example, President Biden recently signed legislation extending the moratorium on automatic 2% Medicare payment cuts through March as the COVID-19 public health emergency continues. Automatic 1% cuts would begin in April and run through June before the full l 2% cuts are resumed in July. However, Dombi conceded there could be some wiggle room in that timeline if COVID-19 cases continue to spike into the spring. The legislation also extends Medicare PAYGO reductions until 2023.
And the Department of Health and Human Services disclosed this week it is releasing $9 billion in phase 4 pandemic relief funding. The list of providers receiving this funding includes many home care companies, Dombi noted. But he added that those who perform private-pay services are not among those on the list, and NAHC has approached the federal government about rectifying this.
