Recently, both the Centers for Medicare & Medicaid Services (CMS) and Occupational Safety and Health Administration (OSHA) released new emergency regulations requiring vaccinations in certain situations. The OSHA rule
requires employers with more than 100 employees to ensure their employees are vaccinated against COVID-19—or are at least masked regularly and tested. This rule has been blocked by a temporary federal court order. CMS issued a corresponding rule
that applies to workers in certain healthcare facilities participating in Medicare or Medicaid. The CMS rule has no masking/testing option in lieu of vaccination for healthcare providers.
The ADA is reviewing the details of both rules to ascertain whether and how they might affect dentists. At this time, the ADA believes the OSHA standard will not impact dental practices with fewer than 100 employees (across all locations) and believes the CMS rule does not cover the typical private dental office, and applies only to dentists working in the following facilities that accept Medicaid:
- Ambulatory Surgical Centers (ASCs)
- Psychiatric residential treatment facilities (PRTFs)
- Programs of All-Inclusive Care for the Elderly (PACE)
- Hospitals (acute care hospitals, psychiatric hospitals, hospital swing beds, long term care hospitals, children’s hospitals, transplant centers, cancer hospitals, and rehabilitation hospitals/inpatient rehabilitation facilities)
- Long Term Care (LTC) Facilities, including Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), generally referred to as nursing homes
- Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID)
- Home Health Agencies (HHAs)
- Comprehensive Outpatient Rehabilitation Facilities (CORFs)
- Critical Access Hospitals (CAHs)
- Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services
- Community Mental Health Centers (CMHCs)
- Home Infusion Therapy (HIT) suppliers
- Rural Health Clinics (RHCs)/Federally Qualified Health Centers (FQHCs)
- End-Stage Renal Disease (ESRD) Facilities
One thing to keep in mind while making decisions related to the emergency rules is the Iowa law recently passed during the last special legislative session, HF902
. This law requires employers to waive a COVID-19 vaccine requirement of an employee if the employee simply submits a statement requesting either a medical or religious exemption. The new Iowa law also allows employees who are terminated due to refusing the COVID-19 vaccine to collect unemployment benefits. Though the federal rules are silent on the issue of unemployment benefits, Iowa’s law conflicts with both the OSHA and CMS emergency rules, which require a healthcare certification for a medical exemption. Since this law directly conflicts with the new federal emergency rules, those employers who are not subject to the CMS or OSHA emergency rules should follow the new Iowa law. Employers who are subject to either the CMS and/or the OSHA emergency rules should follow emergency federal rules, specifically paying attention to the parameters of medical exemptions under the federal mandates.
Please contact IDA staff
with any questions about these new emergency rules or the new Iowa law.