[Updated] Supreme Court Blocks OSHA Mandate, Allows CMS Rule to Take Effect

The long-awaited decisions regarding the Biden administration’s vaccine mandates have finally arrived from the U.S. Supreme Court.

In the end, the Occupational Safety and Health Administration (OSHA) “soft” mandate was shot down by SCOTUS by a 6-3 count. The mandate would have applied to all private businesses with 100 employees or more, requiring workers to either be vaccinated or tested regularly.

However, the Centers for Medicare & Medicaid Services (CMS) mandate – which requires all home health care workers to be vaccinated against COVID-19 – was allowed to stand. The final ruling from SCOTUS was 5-4 in the administration’s favor.

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The latter ruling offers more clarity for home health providers, but does not completely clear the mandate from further litigation.

“Today’s decisions from the U.S. Supreme Court brings home care a step closer to the essential clarity that is needed to determine what is required for compliance,” National Association for Home Care & Hospice (NAHC) President William A. Dombi said in a statement shared with Home Health Care News. “The OSHA rule is blocked from implementation and enforcement for the moment. The CMS rule can take full effect for the moment. Both cases return to the lower courts for further adjudication.”

For now, home health providers will have to begin prepping for fines if they do not reach compliance by Feb. 28, when workers are expected to be fully vaccinated. CMS is requiring staff to have received one COVID-19 vaccine dose by Jan. 27.

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Broadly, a group of states fighting the CMS mandate argued its policy was a legal overreach by the U.S. Department of Health and Human Services (HHS) and Secretary Xavier Becerra.

“[We] agree with the Government that the Secretary’s rule falls within the authorities that Congress has conferred upon him,” the SCOTUS opinion on the CMS mandate states. “Congress has authorized the Secretary to impose conditions on the receipt of Medicaid and Medicare funds that ‘the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services.’”

Click to access 21a240_d18e.pdf


SCOTUS also noted in its opinion that the mandate “fits neatly” into the authorities given to HHS.

“COVID–19 is a highly contagious, dangerous, and – especially for Medicare and Medicaid patients – deadly disease,” the judges continued. “Vaccination requirements are a common feature of the provision of healthcare in America: Healthcare workers around the country are ordinarily required to be vaccinated for diseases such as hepatitis B, influenza, and measles, mumps and rubella.”

The court also ruled that the rule was not “arbitrary and capricious,” as Missouri and a slew of other states had argued in their effort to block the mandate.

Katie Smith Sloan, president and CEO of LeadingAge, called vaccines “the most powerful tools” aging services providers have in their battle against COVID-19.

“They save lives,” she said in a statement. “While mandates can sometimes make it harder for employers to keep or find qualified workers – especially as Omicron surges and workforce challenges are growing – we encourage all members, regardless of care setting or community type, to ensure staff get vaccinated.”

In a statement issued shortly after the Supreme Court news broke, CMS Administrator Chiquita Brooks-LaSure said her agency is “extremely pleased” by the decision.

“CMS is already implementing its health care worker vaccination rule in 25 states and territories that were not covered by preliminary injunctions,” she said. “Today’s decision will enable us to fully implement this rule, and we look forward to working with health care providers and their workers to protect patients. We will continue our extensive outreach and assistance efforts encouraging individuals working in health care to get vaccinated.”

The private-employer mandate, on the other hand, was not viewed by the Supreme Court to be within OSHA’s powers. It would have applied to about 84 million workers.

“Although Congress has indisputably given OSHA the power to regulate occupational dangers, it has not given that agency the power to regulate public health more broadly,” the court wrote in a separate opinion.

The logic of subjecting all workers in these large companies – no matter the demographic of the individual or the industry – was met by members of SCOTUS with significant skepticism.

“Requiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category,” the court wrote, referring to the OSHA mandate’s broadness.

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