Close up of a Doctor making a vaccination in the shoulder of patient.

The CMS Vaccine Mandate: The Nationwide Injunction and What It Means

By Kaitlynn Milvert

On November 30, 2021, a federal district court issued a nationwide preliminary injunction to block the Centers for Medicare and Medicaid Services (CMS) vaccine requirements for health care workers.

This ruling comes mere days before the December 6 deadline for employees of CMS-funded facilities to receive their first dose of a COVID-19 vaccine, and it casts uncertainty over upcoming deadlines for vaccination compliance.

The Mandate

CMS issued an interim final rule on November 5, 2021 that has become known as the “health care worker vaccine mandate.” The rule requires all CMS-funded health care facilities – which encompasses all facilities that accept Medicare or Medicaid funds – to put in place policies to ensure that all staff be vaccinated, subject to limited exceptions. It also sets two deadlines: December 6 for all staff to have received a first dose and January 4 for all staff to be fully vaccinated.

The Injunction

States and health care facilities across the country have filed numerous legal challenges to the CMS rule. The nationwide preliminary injunction issued on November 30 comes in a case brought by 14 states in federal district court in Louisiana. The injunction now puts the CMS vaccine rule on hold until either a final decision is issued in this case or an appeals court reverses the district court’s order.

This injunction goes far beyond a prior injunction that a federal district judge in Missouri had issued the day before, on November 29. That injunction applied across a different group of 10 states that had sued to block the mandate. This new injunction applies to all states not covered by that original 10-state injunction.

The Implications

While the injunction does not prevent health care facilities from establishing their own vaccination requirements for their workers, facilities cannot be held to the CMS rule while the injunction is effect. This leaves health care facilities in an uncertain position in looking ahead to the upcoming January 4 deadline for full vaccination.

In the meantime, it remains to be seen whether CMS will pursue an appeal to overturn the injunction. If the decision is appealed, the Biden administration will likely face an uphill battle. That appeal would be before the Fifth Circuit Court of Appeals — the same circuit that issued a stay blocking enforcement of the Occupational Health and Safety Administration (OSHA) vaccine-or-test mandate.

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