A Louisiana federal court took a giant step forward and blocked the Centers for Medicaid and Medicare Services (CMS) from enforcing its COVID-19 vaccine mandate. This news comes on the heels of the decision made in a Missouri federal court which temporarily paused the CMS mandate in only ten states. The new Louisiana action paused the mandate for any state that did not fall under the ruling in Missouri.
Late Tuesday, the Louisiana judge issued a 34-page order that contends the government does not have the authority required to implement the vaccine mandate. Therefore, the ruling is on hold for the time being.
Learn More About Vaccine Mandates and What Facilities Need to Know
What is the CMS Vaccine Mandate?
Regardless, the January 4th deadline is fast approaching. Healthcare employees are feeling the squeeze as the pressure intensifies for all to receive the vaccine. The ruling from CMS requires all workers at facilities that accept Medicare or Medicaid payments to be covered by January 4, 2022. December 6 is the deadline for the first vaccination dose and requests for accommodations.
Timeline of Events that Led to the Current Situation
Here is a quick rundown of what’s happened in November that’s led up to this:
- On November 5, the CMS issued a rule that would require a workplace vaccine mandate for suppliers and providers that receive payment from Medicaid and/or Medicare programs. Employees, students, contractors, volunteers, and “staff” were to be fully vaccinated against the COVID-19 virus by January 4, 2022, according to the rule. Furthermore, December 6 was set as the deadline for people to have had the first vaccine, and any requests for accommodations to have been made.
- Ten states collectively issued a formal complaint to the Missouri federal court on November 29th that challenged the legality of enforcing such a mandate. The court granted the request to temporarily block the mandate, but it only applied to the healthcare workers that were in the following ten states:
- Alaska
- Arkansas
- Iowa
- Kansas
- Missouri
- Nebraska
- New Hampshire
- North Dakota
- South Dakota
- Wyoming
- In Louisiana, another 14 states took action and filed a similar complaint on November 30th:
- Arizona
- Alabama
- Georgia
- Idaho
- Indiana
- Kentucky
- Louisiana
- Mississippi
- Montana
- Ohio
- Oklahoma
- South Carolina
- Utah
- West Virginia
- It was this lawsuit that birthed the new Legislation out of Louisiana that led to the nationwide order blocking the CMS vaccine mandate for all healthcare workers across the country that were not included in the original ten states.
Ruling Handed Down By Louisiana Court
The Louisiana federal court did the same thing in the Missouri case. They entered a preliminary injunction against the CMS vaccine mandate. Their position held that they would suffer irreparable and immediate harm with the ruling and demonstrated a likelihood of success on the merits. Five key findings highlighted concluded that the states would likely prevail against any new litigation attacking the mandate:
1. Standard Processes Were Not Followed By Federal Authorities
CMS was faulted for not using the standard notice-and-comment period that is necessary for the interested parties to provide opinions and weigh in on such a ruling. The federal agency stated it had “good cause” to bypass the normal process, but the court did not agree with CMS.
2. CMS is Not Authorized to Issue a Vaccine Mandate
According to the court, the principle of separation of powers weighed in the decision of striking down the mandate, because a ruling that impacts millions of workers should have been handled by lawmakers at the federal level in the judicial branch and not by the executive-branch federal bureaucrats. According to the court:
“There is no question that mandating a vaccine to 10.3 million healthcare workers is something that should be done by Congress, not a government agency. It is not clear that even an Act of Congress mandating a vaccine would be constitutional. Certainly, CMS does not have this authority by a general authorization statue.”
3. The CMS Vaccine Mandate is Contrary to the Law
The judge also listed provisions of law that the CMS did not follow when they implemented this vaccine mandate. One of those includes the applications of the Social Security Act, which requires CMS to advise agencies of the state prior to the roll-out of such a ruling. Furthermore, the court noted that CMS failed to do any regulatory analysis on the impact this mandate would have on the rural, community, or small hospitals - noting that the loss of federal funds could be “significant”.
4. The Ruling is “Arbitrary and Capricious”
According to the court, CMS did not follow reasoned decision-making when it created and issued this rule and therefore was arbitrary and capricious. The court noted, “The goal of the CMS Mandate is to increase individual vaccine rates,” but according to the judge “will actually have the effect of harming patient well-being due to staff shortages of providers and suppliers. This is backed up by a number of declarations of various individuals that verify healthcare worker shortages, a significant number of healthcare workers that remain unvaccinated, and the harm that will be caused to these facilities in the event that even a few of the unvaccinated healthcare workers quit or are fired as a result of the CMS Mandate.”
Furthermore, the court pointed out that the CMS failed to consider what they called “obvious” alternatives to the mandate, which includes but is not limited to:
- Masks
- Shields
- Weekly testing
- Social distancing
- Natural immunity
5. The CMS Vaccine Mandate Violates Constitutional Principles
Various constitutional provisions were cited by the court that this mandate violates, including:
- The Spending Clause
- The Tenth Amendment
- The Anti-Commandeering Doctrine
This Ruling Could Be Overturned
Nothing is certain at this time. This court order could be overturned by the Supreme Court or a court of appeals. Healthcare workers are left in a state of confusion and uncertainty on what they should do as they wait for a final decision.
What’s Next for Healthcare Workers and Vaccine Mandates?
Just as the entire pandemic has played out, it’s hard to tell what lies around the corner for this CMS vaccine mandate. Will they press forward with the January 4th deadline? To keep up to date with this and other relevant healthcare news, stay posted at the NursaTM blog. New to NursaTM?
Download the app today and find PRN jobs for registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), and allied health workers. Picking up per diem shifts may help you out if you are in a state of uncertainty at the moment while decisions are being made regarding the CMS vaccine mandate. NursaTM has jobs posted in real-time from all types of hospitals and healthcare facilities with various requirements.
