CMS already has a similar but less extensive mandate to offer flu vaccinations in place.

CMS Extending Flu Vaccination Requirement

Its proposed vaccination standard covers both annual and pandemic flu and would affect Medicare and Medicaid participating hospitals of all types.

The Centers for Medicare & Medicaid Services (CMS) published a rule May 4 that will require all hospitals participating in Medicare or Medicaid to offer all of their patients an annual influenza vaccination, unless it is medically contraindicated or the patient or patient's representative or surrogate declines vaccination. The rule also will require certain providers and suppliers to develop policies and procedures allowing them to offer vaccinations for pandemic flu.

CMS is accepting comments on the proposal until July 5. "Due to the benefits that these provisions are estimated to offer, we plan, after consideration of any comments received, to publish the proposed regulations as final in the early Fall of 2011, with the intent that they would become effective during the 2011 through 2012 influenza season," the agency's regulatory text said.

The rule would apply to all types of participating hospitals, including short-term acute care, psychiatric, rehabilitation, long-term care, children's, and cancer hospitals; critical access hospitals; rural health clinics; federally qualified health centers; and end-stage renal disease facilities. "We have proposed this standard for these provider and supplier types because we believe that each of them have -- (a) RNs or other appropriately licensed medical personnel present when serving patients; and (b) the ability to manage vaccination and vaccine supplies with minimal additional cost or complications (for example, they already store and manage medications)," CMS stated. "We believe that the potential consequences of not finalizing this rule as soon as possible far outweigh the burden that would be imposed on providers and suppliers. We welcome your comments on these publication and implementation plans."

CMS already has a similar but less extensive mandate in place. Its October 2002 final rule for hospitals, long-term care facilities, and home health agencies removed the patient-specific physician order requirement for administering flu and pneumococcal vaccines. In October 2005, it published a final rule requiring participating nursing homes to offer all residents an annual influenza vaccination. That rule was successful because it boosted the vaccination rate in the long-term care population to 90 percent in the first year the rule was effective, according to the agency, which said the current national average for flu vaccinations administered to long-term care residents is about 91 percent.

To file a comment, visit and search for CMS-3213-P.

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