Summary of President Biden’s Executive Order

On September 9, President Biden issued a stunning and far-reaching executive order related to the continual COVID pandemic. While the current buzz is related to vaccination of healthcare workers, the Order actually has six components

  1. Mandatory vaccination of:
    • All healthcare workers
    • All employees of businesses with more than 100 employees (or weekly testing)
    • All Federal employees
    • Required paid time off for employees to get vaccinated
    • Proof of vaccination for all large-scale venues (concerts, sporting events, etc.)
  2. Further protections for vaccinated individuals:
    • Easy access to boosters for all eligible individuals
  3. Keeping schools safely open
    • All states to adopt vaccination requirements for school employees
    • Use of Department of Education authority to override state mask prohibition order
    • Increase access to testing for staff and students
  4. Increased testing and mask mandates
    • Increase access to inexpensive, in-home testing
    • Increase access to free community testing centers
    • Expand free testing at pharmacies
    • Mask requirement for interstate travel extended with doubled fines
    • Mask requirement on all Federal property
  5. Protecting economic recovery
    • Strengthening EIDL loan program for small business
    • Streamlining PPP forgiveness
  6. Improved care for those with COVID

At this time, we only want to address the vaccination issue which is receiving the most attention. There is a good deal of information spreading on the blogs so beware. This is what we feel we know and do not know at this point.

  • We DO know the Order applies to all providers and all healthcare workers (whether they work directly with patients or not) in Medicare certified facilities. Per CMS definition, a facility includes all physicians and a certified facility is one that is approved to receive Medicare or Medicaid payments. So, unless you do not accept Medicare/Medicaid, you are included. A CMS MLN newsletter issued the same day states that providers should make every effort to prepare for the requirement.
  • We DO know this Order overrides any State regulations or mandates.
  • We do NOT know what the implementation dates will be. CMS has stated they will issue a final rule sometime in October. In states with existing mandatory vaccination rules, most state the initial vaccination must occur within 30 days of the rule and complete vaccination within 6-8 weeks of the rule.
  • We do NOT know what the exemptions to the rule will be. It is likely they will follow the existing OSHA exemptions of medical, disability or sincerely held religious belief.
  • We do NOT know what documentation will be required for exemption. It is also likely to follow the rules of states with existing rules which typically require physician certification of medical or disability exemption. For religious exemption, the employee is required to provide a written explanation of why vaccination violates their religious beliefs.
  • We DO know the mandatory vaccination for all employees with businesses with over 100 employees is a SEPARATE mandate that will impact certain other groups where optometrists (and employees) may work including private equity groups, research, universities, veterans facilities and the like.

We definitely know this Order will be very disruptive within the workforce and likely affect your practice from a manpower standpoint. We also definitely know that legal challenges will come out of the woodwork on this!

PCS wants to emphasize that these mandates/initiatives will require development within their respective agencies. Those details will likely be available over the next thirty days and PCS will keep you updated.

– the PCS Team