USSC Upholds Vaccination Mandate For Health Care Facilities

CATEGORY: Client Update for Public Agencies, Fire Watch, Law Enforcement Briefing Room, Public Education Matters
CLIENT TYPE: Public Education, Public Employers, Public Safety
DATE: Feb 10, 2022

In November 2021, the U.S Secretary of Health and Human Services announced that, in order to receive Medicare and Medicaid funding, participating facilities must ensure that their staff – unless exempt for medical or religious reasons – are vaccinated against COVID-19.  A facility’s failure to comply may lead to monetary penalties, denial of payment for new admissions, and ultimately termination of participation in the programs.  The Secretary issued the rule after finding that vaccination of health care workers against COVID-19 was necessary for the “health and safety of individuals [for] whom care and services are furnished.”  The Secretary issued the rule as an interim final rule, rather than through the typical notice-and-comment procedures, after finding “good cause” that the rule should be effective immediately.

Shortly after the interim rule’s announcement, two groups of states filed separate actions challenging the rule. After two district courts enjoined enforcement of the rule, the Government requested that the U.S. Supreme Court (“USSC”) lift the injunctions.

On appeal, the USSC lifted the injunctions. The USSC reasoned that the Secretary’s rule fell within his authority to impose conditions on the receipt of Medicare and Medicaid funds that “the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services.”  Because COVID-19 is a contagious and dangerous disease – especially for Medicare and Medicaid patients – the USSC found the rule fit squarely within the Secretary’s power.  In addition, the USSC noted that healthcare facilities that wish to participate in Medicare and Medicaid have always been obligated to satisfy a host of conditions.  The Secretary also routinely imposes conditions that relate to the qualifications of healthcare workers.

The USSC rejected the states’ remaining contentions, finding that the interim rule was not arbitrary or capricious and that the interim rule did consider that it might cause staffing shortages in some areas.  It also found that the Secretary had valid justification to forgo notice and comment.  Accordingly, the USSC upheld the vaccination mandate for employees in health care facilities.

Biden v. Missouri, 142 S. Ct. 647, 651 (2022).


In California, this decision should have minimal impact since the California Department of Public Health (CDPH) already requires that health care facilities ensure their workers are fully vaccinated against COVID-19.

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