A third of unvaccinated Americans were unsure if their insurance covered the vaccine.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act passed last spring prohibits providers from charging patients for COVID vaccinations, and the Centers for Disease Control and Prevention (CDC) doubled down by requiring providers to sign an agreement that they won’t do so. Commercial insurance and government plans are required to pay for any fees to providers for administering the shots, and the government has set up a fund through the U.S. Health Resources and Services Administration (HRSA), through which providers can get reimbursed for uninsured patients. In short, under a number of laws and programs, individuals should not be paying anything to get vaccinated.
However, a recent Kaiser Family Foundation survey found that a third of unvaccinated Americans were unsure if their insurance covered the vaccine, leading U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra to write a letter to both providers and payors, reminding them that patients should not be charged.
According to the New York Times, it’s not clear that any substantial number of patients have actually been charged and then subsequently paid for a vaccination. But Becerra and others are worried about the perception of possible costs, which may be one factor that keeps individuals from getting the vaccine. According to researchers quoted in the Times, this perception reflects a general distrust in the health system, based on experiences with unexpected medical bills.
On a related note, for one group of Americans, the vaccine is quickly becoming a requirement for employment. Hospital systems across the country – including New York-Presbyterian and New Jersey’s RWJBarnabas – are requiring their employees to become vaccinated before September or find another job.
Houston Methodist was one of the first hospitals to require employees to be vaccinated. A group of that hospital’s employees filed suit last month against the requirement, citing the fact that while the Food and Drug Administration (FDA) has approved vaccines for emergency use, they had not been fully approved. Over this past weekend, a federal judge dismissed the lawsuit, saying that the hospital’s decision to mandate vaccinations for its employees was consistent with public policy.
As health systems move toward requiring employees to be vaccinated, hospitals must also implement the long-awaited COVID safety standards released on Friday by OSHA, the Occupational Safety and Health Administration.
The standards, which only apply to hospitals, nursing homes, and other healthcare workplaces, now mandate many of the safety precautions that have been in place for over a year, including the use of personal protective Equipment (PPE), social distancing and masking, ventilation requirements, and daily employee health screenings. The difference now, however, is that hospital are required to implement these protections.
The new OSHA hospital rules do say that fully vaccinated workers are exempt from masking and social distancing when they are in “well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present.”
While the new OSHA rules do not apply to workplaces outside healthcare settings, OSHA did update its guidance for other workplaces, and that guidance reflects the CDC’s most recent recommendations for vaccinated individuals.
In such workplaces, OSHA suggests, employers no longer need to take steps to protect vaccinated employees. Vaccinated employees no longer need to wear masks or practice social distancing, but unvaccinated and high-risk employees must continue to do so.
This poses something of a problem, because neither OSHA nor the CDC have given guidance about workplaces in which the employer does not know which employees have been vaccinated – and to date, only a small percentage of employers track any such metrics. So, how should employers in those situations apply protective policies in a mixed vaccinated workforce?
It will be interesting to see whether this new OSHA guidance will push more employers to ask their employees whether they’ve been vaccinated – or, like Houston Methodist and other hospitals, make vaccinations a requirement of employment.
Programming Note: Listen to Matthew Albright’s live reporting on legislative issues, every Monday on Monitor Mondays at 10 Eastern and sponsored by Zelis.
The term “stopgap” is defined as “a temporary way of dealing with a problem, and something used as an emergency measure until something better can
Readers last week surely noted my coverage of a few of the key regulatory initiatives the Biden Administration intends to undertake during the last part
Please log in to your account to comment on this article.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
Copyright © 2025 RACmonitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
