COVID Vaccine Resources | APMA
COVID Vaccine Resources

APMA, the CDC, and CMS provide information, recommendations, and guidance regarding the COVID-19 vaccination.

Become a Vaccinator

Biden Administration Vaccine Mandate Regulations

CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule with Comment Period

This interim final rule with comment period revises the requirements that most Medicare- and Medicaid-certified providers and suppliers must meet to participate in the Medicare and Medicaid programs. CMS states that changes are necessary to help protect the health and safety of residents, clients, patients, PACE participants, and staff, and reflect lessons learned to date as a result of the COVID-19 public health emergency. The revisions to the requirements establish COVID-19 vaccination requirements for staff at the included Medicare- and Medicaid- certified providers and suppliers.

  • Press Release
  • CMS Webinar: Omnibus COVID-19 Health Care Staff Vaccination (slide deck; PDF)
  • Frequently Asked Questions
  • Due to ongoing litigation, we encourage members to visit CMS’ COVID-19 website directly for latest updates to the Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule. We encourage members to review all FAQs thoroughly, but APMA notes two relevant questions:

    Q: To which provider and supplier types does this apply?
    A: The staff vaccination requirement applies to the following Medicare and Medicaid-certified provider and supplier types: Ambulatory Surgery Centers, Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, End-Stage Renal 2 Disease Facilities, Home Health Agencies, Home Infusion Therapy Suppliers, Hospices, Hospitals, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services, Psychiatric Residential Treatment Facilities (PRTFs) Programs for All-Inclusive Care for the Elderly Organizations (PACE), Rural Health Clinics/Federally Qualified Health Centers, and Long-Term Care facilities.

    Q: Would a physician with admitting privileges in a hospital be covered under this requirement?
    A: Yes, a physician admitting and/or treating patients in-person within a facility subject to the CMS health and safety regulations and included as a part of this requirement must be vaccinated so that the facility is compliant.

    Q: Is a physician who acts as a physician DME supplier in their private practice considered a covered facility (and therefore all staff as well) under this requirement?
    A: No. But these employees may still be covered under OSHA's Healthcare Emergency Technical Standards issued in June 2021.

    Q: Are there any exemptions for this mandate?
    A: CMS requires facilities to allow for exemptions to staff with recognized medical conditions for which vaccines are contraindicated (as a reasonable accommodation under the Americans with Disabilities Act [ADA]) or religious beliefs, observances, or practices (established under Title VII of the Civil Rights Act of 1964). Providers and suppliers should establish exceptions as a part of its policies and procedures and in alignment with Federal law. CMS believes that exemptions could be appropriate in certain limited circumstances, but no exemption should be provided to any staff for whom it is not legally required (under the ADA or Title VII of the Civil Rights Act of 1964) or who requests an exemption solely to evade vaccination.

Masks 

Members have asked APMA about mask requirements and face coverings in podiatric offices in light of recent (May 16, 2021; updated September 16, 2021) CDC guidance for those fully vaccinated. APMA recommends that podiatric offices comply with state or local jurisdiction rules regarding face-covering requirements as they apply to businesses and health-care settings.  

You should encourage your unvaccinated patients to follow recommendations on How to Protect Yourself and Others. APMA also recommends that podiatric physicians encourage eligible patients to get vaccinated and receive booster shots, as appropriate. 

Additional Guidance for Daily Activities; Guidance for Activities, Gatherings, and Holidays; and, Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic are available from the CDC.  

APMA is not providing legal advice and encourages members to speak with a duly licensed attorney in their jurisdiction. 

Advocacy and Policy Positions

To support members and podiatric offices, APMA has engaged state and federal policymakers on the administration of vaccinations and following are recent examples of successful efforts: 

APMA’s House of Delegates has adopted the following policy propositions regarding vaccinations: 

Policy Proposition 2-21: Podiatric Physician Routine Immunization 

APMA encourages doctors of podiatric medicine to be routinely immunized, especially when safe and effective vaccines are available, and especially for diseases that have potential to become epidemic or pandemic (e.g., influenza or SARS-CoV-2). Vaccines are essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks. Vaccine-preventable diseases can be a threat to our health and vaccines can provide population-wide protection against disease. Notwithstanding, APMA recognizes and respects that some doctors of podiatric medicine may be unable to take certain vaccinations for medical reasons or because of firmly held religious beliefs, and APMA encourages such individuals to take appropriate precautions in effort to avoid spreading communicable diseases. 

Policy Proposition 3-21: Podiatric Physicians Administering Vaccines  

APMA supports including podiatric physicians, and podiatric residents, and podiatric medical students in the pool of professionals who can administer vaccines, especially when called upon in times of need for a disease that has potential to become epidemic or pandemic (i.e., influenza or SARS-CoV-2). Podiatric physicians and surgeons undergo education and training like their allopathic and osteopathic physician colleagues and possess more than enough experience to administer vaccines. Doctors of podiatric medicine are licensed, independent practitioners, and as such, APMA urges federal, state, and local governments to authorize podiatric physicians and podiatric residents to administer vaccines without any supervision requirements. 

General Vaccine Information

APMA's regulatory consultant, Hart Health Strategies Inc., has prepared a COVID resource document on the topic of COVID vaccines. 

The CDC provides a printable COVID-19 resource you can display in your office or provide to your patients. 

Information on the different COVID-19 vaccines, including information on vaccines in clinical trials, is available from the CDC.  

The CDC provides information on Who Is Eligible for a COVID-19 Vaccine Booster Shot and the We Can Do This campaign has infographics and social media content you can share.

The New England Journal of Medicine (NEJM) has a COVID-19 Vaccine Resource Center, which features a collection of resources on COVID-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.  

Vaccine Administration 

CMS provides information related to COVID-19 vaccine administration to ensure the vaccine is covered and available free of charge for every American. CMS also has a tool kit regarding vaccine administration specifically for health-care providers. 

Clinical resources from the CDC are available for administration, storage and handling, patient education, and more for COVID-19 vaccine. 

The CDC has information for preparing your practice for COVID-19 vaccination. 

CMS has published information about the COVID-19 vaccine payment rate, vaccine coding guidance, and how to bill for COVID-19 shot administration.  

If you participate in the CDC COVID-19 Vaccination Program, you must: 

  • Administer the vaccine with no out-of-pocket cost to your patients for the vaccine or administration of the vaccine 
  • Vaccinate everyone, including the uninsured, regardless of coverage or network status 

You also can't: 

  • Balance bill for COVID-19 vaccinations 
  • Charge your patients for an office visit or other fee if COVID-19 vaccination is the only medical service given 
  • Require additional medical or other services during the visit as a condition for getting a COVID-19 vaccination 

FAQ

Q: Can podiatrists prescribe and/or administer vaccines for COVID-19?

On March 11, HHS made an amendment to the Public Readiness and Emergency Preparedness (PREP) Act Declaration to allow more qualified professionals to prescribe, dispense, and administer COVID-19 vaccinations, including podiatrists, recently retired podiatrists, and podiatric medical students. HHS has determined that the PREP Act clearly preempts state law. Therefore, regardless of scope of practice restrictions, DPMs, retired DPMs, and students may serve as vaccinators so long as they meet certain conditions. Ultimately, states and territories may choose which qualified persons to use for vaccinations in their jurisdiction. Read more: Biden Administration Authorizes DPMs, Students to Administer COVID-19 Vaccine.

Become a Vaccinator

Several states have already authorized podiatrists to administer vaccines, and as of April 1, 2021, APMA is aware of nine states that have taken action:

State requirements that do not effectively prohibit qualified persons, such as additional training, are not preempted by the PREP Act. You will need to contact the state department of health for more information or to ask questions.

APMA encourages members to contact their state health department or licensing board for more information. 

The CDC has materials for preparing your practice for COVID-19 vaccination, including the CDC's Vaccine Training Modules and a printable "Facts about COVID-19 Vaccines" resource you can provide to your patients.

Q: Can podiatrists require their office staff to receive the COVID-19 vaccination?

Generally, you can require your employees to get vaccinated if by not getting the vaccine they pose a direct threat to customers or other employees. In the context of a physician's office, it is probably easy to demonstrate that employees would pose a direct threat to patients if the employee was not vaccinated. 

However, any policy that requires employees to receive the COVID-19 vaccine must comply with the Americans with Disabilities Act, Title VII of the Civil Rights Act of 1964, and other workplace laws.The Equal Employment Opportunity Commission has provided guidance to employees in Section K ofWhat You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. 

Note: See Sections K.5, K.6, and K.7 on when employers must provide a disability or religious exemption or a reasonable accommodation to employees.

More information is also available from the Society for Human Resource Management regarding what employers can do if workers refuse a COVID-19 vaccination and when employers can require COVID-19 vaccinations.

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