Biden Vaccine Mandate Plan Mostly Excludes Small Medical Practices
By Sean Price


Earlier this month, President Joe Biden introduced a six-point plan that mandates COVID-19 vaccines for millions of Americans. Many details of the plan are still being developed as specific regulations are written, but at least one aspect of the plan is clear: The vaccination mandate for “over 17 million health care workers at Medicare and Medicaid-participating hospitals and other health care settings,” largely does not apply to small physician practices, according to Texas Medical Association analysis. 

The requirement clearly affects physicians who work in large medical facilities, but those in office-based practices aren’t subject to the facility-based requirement for COVID-19 vaccines,  says Robert Bennett, TMA vice president for medical economics. 

“There is confusion on this point – people think this applies to physician offices when it doesn’t,” he added. “It applies to hospitals and [large] facilities.” 

The plan will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities. But the definition of “facilities” used by the Centers for Medicare & Medicaid Services (CMS) covers only large institutions such as hospitals, nursing homes, federally qualified health centers, and ambulatory surgical centers, Mr. Bennett says. 

However, private physicians may have to adhere to the mandate if they work in hospital and facility settings. This could include anesthesiologists, radiologists, and other physicians who are private contractors. The Biden administration has not released enough details to fully assess hospital-based physicians’ status; that information is expected to be released in October. 

The Biden plan also would require all employers with 100 or more employees to ensure their workers are vaccinated for COVID-19 or tested for the disease weekly. The Department of Labor’s Occupational Safety and Health Administration (OSHA) is developing this rule, which is expected to be released in October or sooner. 

“This requirement will impact over 80 million workers in private sector businesses with 100-plus employees,” according to the White House announcement

Again, the OSHA rule does not appear to affect most small, private practices, Mr. Bennett says. However, the 100-employee rule covers practices that use 100 “full-time equivalents” – meaning full- and part-time workers who do the work of 100 full-time employees. 

“There would be a lot of large group practices that would fall under this,” Mr. Bennett said. 

The lack of any written regulations from CMS or OSHA makes it challenging to determine the status of physicians or how many would be affected, he said. But for those facilities that are clearly included, the rule will take effect within days after it is released. The Biden administration’s Sept. 10 announcement called on facilities to prepare for its enforcement. 

“The announcement indicated facilities should start vaccinating your facility employees now so that you’re in compliance when this regulation comes out,” Mr. Bennett said. 

Read Texas Medicine Today for further analysis of the Biden plan as it becomes available.

Last Updated On

September 28, 2021

Originally Published On

September 27, 2021

Related Content

Coronavirus | Immunization

Sean Price


(512) 370-1392

Sean Price is a reporter for Texas Medicine and Texas Medicine Today. He grew up in Fort Worth and graduated from the University of Texas at Austin. He's worked as an award-winning writer and editor for a variety of national magazine, book, and website publishers in New York and Washington. He's also helped produce Texas-based marketing campaigns designed to promote public health. Sean lives in Austin and enjoys hiking, photography, and spending time with his wife and two sons.

More stories by Sean Price