Florida hospitals continue to feel squeezed between competing state and federal COVID-19 vaccine directives, even as a U.S. Supreme Court ruling on the legality of the Biden administration’s vaccine mandate for employers is imminent.
“Hospitals are absolutely stuck between a rock and a hard place,” Mary Mayhew, president and CEO of the Florida Hospital Association, told the Florida Record. “First and foremost, hospitals are absolutely committed to the Medicare program and to meeting the needs of millions of elderly Floridians.”
The problem is that the federal Centers for Medicare and Medicaid Services (CMS) is implementing the Biden administration’s vaccine mandate for health care workers in 25 states, including Florida. These states are not affected by federal court orders stopping the enforcement of the mandate.
The federal rule, which begins to take effect this month in those states, mandates that 100% of the workers get the vaccine or face a testing regimen. Failure to follow the rule can ultimately result in a hospital being terminated from the Medicare program – a financial death sentence for many health care facilities.
At the same time a Florida law prohibits such vaccine mandates unless a large number of exemptions are put in place, including religious and health exemptions, and employee terminations that violate such provisions are not allowed. Hospitals violating the rules can face administrative fines of up to $50,000 per violation, according to the state Agency for Health Care Administration (AHCA).
Florida hospitals are seeking clarification on whether the state law would still be in force if a U.S. Supreme Court opinion supporting the federal mandate is issued, Mayhew said.
“We clearly need clarity regarding federal preemptions,” she said. “… If it is clear that the CMS rule is on solid ground, we still have the conflict in Florida with the state law, and ultimately we’ll need it resolved in the courts regarding federal preemption."
The state law and federal rule are not compatible, according to Mayhew, and hospitals want to avoid state enforcement actions against any health care provider subject to the CMS rule and seeking to comply.
As the conflict wears on, no hospitals have moved forward on terminations related to upcoming CMS deadlines, she said.
““Hospitals are confronting yet another (COVID-19) surge, and they are doing it while also experiencing one of the worst workforce shortages they have ever seen," Mayhew said. "... They're in a no-win situation."
Meanwhile, the AHCA said in a recent letter that it would follow Florida law and would not survey health facilities for CMS vaccine mandate compliance. The federal government, however, could send surveyors to Florida to enforce the mandate, according to Mayhew.