Skip to Main Content

November 12, 2021

Health Law Weekly

Ten States Sue to Block CMS Vaccination Requirement for Health Care Workers

  • November 12, 2021

A coalition of ten states is suing to block an emergency regulation issued last week by the Centers for Medicare & Medicaid Services (CMS) requiring an estimated 17 million health care workers in hospitals and other facilities and settings that participate in Medicare and Medicaid to be fully vaccinated for COVID-19.

The lawsuit, which was filed November 10 in a Missouri federal district court, argues the CMS interim final rule (86 Fed. Reg. 61555) could exacerbate health care workforce shortages, particularly in rural areas.

The states contend that CMS violated the Administrative Procedure Act in promulgating the rule and that the nationwide vaccine requirement for health care workers runs afoul of the Tenth Amendment and federalism. The lawsuit asks the court to enjoin the government from enforcing the mandate.

Missouri Attorney General Eric Schmitt and Nebraska Attorney General Doug Peterson are leading the state coalition, joined also by the attorneys general of Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota, and New Hampshire.

Under the interim final rule, health care providers must establish policies to ensure all eligible staff receive the first dose of a COVID-19 vaccine before providing any care, treatment, or other services by December 5, 2021. By January 4, 2022, all eligible workers must have received the necessary doses to be fully vaccinated. 

The move is part of the administration’s broad-based effort to counter the spread of COVID-19 in the face of the highly transmissible Delta variant. Also last week, the Occupational Safety and Health Administration (OSHA) released a much-anticipated emergency temporary standard requiring all businesses with 100 or more employees to ensure their workers are fully vaccinated or are tested on a weekly basis.

The Fifth Circuit, however, granted November 6 an emergency motion to stay enforcement of the OSHA vaccine and testing requirements, citing “grave statutory and constitutional issues.”


  • Coronavirus Pandemic Hub