OSHA Withdraws Most Provisions of the Healthcare ETS
From the National Association for Home Care and Hospice
On June 21, 2021, OSHA adopted a Healthcare Emergency Temporary Standard (Healthcare ETS) protecting workers from COVID-19 in settings where they provide healthcare or healthcare support services. 86 FR 32376. Under the OSH Act, an ETS is effective until superseded by a permanent standard – a process contemplated by the OSH Act to occur within 6 months of the ETS’s promulgation. 29 U.S.C. 655(c).
OSHA announces today that it intends to continue to work expeditiously to issue a final standard that will protect healthcare workers from COVID-19 hazards, and will do so as it also considers its broader infectious disease rule making. However, given that OSHA anticipates a final rule cannot be completed in a timeframe approaching the one contemplated by the OSH Act, OSHA also announces today that it is withdrawing the non-record keeping portions of the healthcare ETS. The COVID-19 log and reporting provisions, 29 CFR 1910.502(q)(2)(ii), (q)(3)(ii)-(iv), and (r), remain in effect. These provisions were adopted under a separate provision of the OSH Act, section 8, and OSHA found good cause to forgo notice and comment in light of the grave danger presented by the pandemic. See 86 FR 32559.
With the rise of the Delta variant this fall, and now the spread of the Omicron variant this winter, OSHA believes the danger faced by healthcare workers continues to be of the highest concern and measures to prevent the spread of COVID-19 are still needed to protect them. Given these facts, and given OSHA’s anticipated finalization of this rule, OSHA strongly encourages all healthcare employers to continue to implement the ETS’s requirements in order to protect employees from a hazard that too often causes death or serious physical harm to employees.
As OSHA works towards a permanent regulatory solution, OSHA will vigorously enforce the general duty clause and its general standards, including the Personal Protective Equipment (PPE) and Respiratory Protection Standards, to help protect healthcare employees from the hazard of COVID-19. The Respiratory Protection Standard applies to personnel providing care to persons who are suspected or confirmed to have COVID-19. OSHA will accept compliance with the terms of the Healthcare ETS as satisfying employers’ related obligations under the general duty clause, respiratory protection, and PPE standards. Continued adherence to the terms of the healthcare ETS is the simplest way for employers in healthcare settings to protect their employees’ health and ensure compliance with their OSH Act obligations.
OSHA believes the terms of the Healthcare ETS remain relevant in general duty cases in that they show that COVID-19 poses a hazard in the healthcare industry and that there are feasible means of abating the hazard. OSHA plans to publish a notice in the Federal Register to implement this announcement.
It is unclear what OSHA’s expectations are for providers in relation to its Vaccination and Testing ETS if healthcare providers continue to follow the provisions of the OSHA Healthcare ETS. The National Association for Home Care & Hospice will continue to follow the developments closely and provide updates as we learn more. |
Supreme Court Sets Jan. 7 Special Hearing on Vaccine Mandate for Healthcare Workers
Fierce Healthcare
The Supreme Court is fast-tracking two legal cases challenging President Joe Biden's COVID-19 vaccine mandates, including a requirement for certain healthcare workers.
The high court announced Wednesday it will hold a special hearing Jan. 7 to hear oral arguments over federal vaccine mandates that are at the heart of the Biden administration’s efforts to address COVID in the workplace.
The Supreme Court's decision comes as the omicron variant is causing COVID-19 cases to surge nationwide.
In an unusual move, the court said it would move with exceptional speed on the two measures, a vaccine-or-testing mandate aimed at large employers and a vaccination requirement for certain healthcare workers, The New York Times reported Wednesday. The justices had not been scheduled to return to the bench until the following Monday.
The high court will hear arguments over a rule issued by the Occupational Safety and Health Administration (OSHA) that applies to employers with 100 or more workers and requires they have all staff vaccinated or tested for the virus weekly. The rule could affect more than 84 million workers.
The second is a rule released by the Centers for Medicare & Medicaid Services (CMS) in November that requires hospitals, ambulatory surgery centers, nursing homes and other healthcare facilities to ensure staff are fully vaccinated by Jan. 4 or risk losing Medicare and Medicaid funding.
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LAN Survey: 40% of Health Payments Tied to Alternative Payment Models in 2020
Fierce Healthcare
Roughly 40% of U.S. healthcare payments were tied to alternative payment models (APMs) last year, with Medicare Advantage claims representing the largest amount, a new survey found.
The survey, published Wednesday by the Health Care Payment Learning & Action Network, showed that more work needs to be done as most healthcare payments were still tied to a fee-for-service model.
“The survey shows we have made limited progress in moving away from fee for service between 2019 and 2020,” said Mark McClellan, M.D., Ph.D., director of Duke University’s Margolis Center for Health Policy and co-chair of the LAN CEO forum, during the LAN Summit Wednesday. “Most payments are still in fee-for-service, especially outside of Medicare.”
The report found that 38.2% of healthcare payments in 2019 and 40.9% of payments in 2020 were tied to an APM. The percentage of payments tied to value increased from 35.8% in 2018.
However, the percentage is below the network’s goal of 50% by 2018.
The network surveyed 73 health plans, five Medicaid states and traditional Medicare, representing 80% of the national market.
LAN also looked at the percentage of healthcare payments along payer types. Medicare Advantage had the highest amount of dollars tied to an APM, with 50% in 2019 and 58% in 2020.
Meanwhile, the commercial insurance business had 32% of its dollars in an APM for 2019 and only slightly increased to 35% the next year.
Traditional Medicare payments stayed relatively flat from 2019 to 2020, with nearly 42% in 2019 and 42.8% last year. But payers broadly support shifting toward value-based care. LAN found that 92% of respondents believe APMs can lead to better quality of care, and 85% think it can lower costs.
However, key challenges are a willingness among providers to take on financial risk and the ability to operationalize those risks…
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Omicron Variant Will Dominate in U.S. Within Weeks, Fauci Says
Bloomberg
The omicron variant of the Covid-19 virus will assume a dominant role in the U.S. “very soon,” possibly within a few weeks, said Anthony S. Fauci.
“We’re looking over our shoulder at omicron,” Fauci, President Joe Biden’s chief medical adviser for Covid-19, said at a U.S. Chamber of Commerce Foundation event. The latest variant of concern, which scientists in South Africa first identified around Thanksgiving, will start to dominate in the U.S. “I would imagine within a period of a few weeks as we go into January,” he said.
The delta variant remains the main source of infections in the U.S., accounting for 96% of cases, Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Wednesday during a White House press briefing. That means delta is largely responsible for the latest surge to 117,900 cases per day. Cases were down to less than 60,000 per day back in July.
“Delta is still a serious problem,” Fauci said. With the uptick of delta-related infections, the country getting into “the depths of winter,” and “with omicron breathing down our back, things could get really bad, particularly for the unvaccinated.”
But he said that those who are vaccinated and boosted will be relatively well protected against severe disease.
The omicron variant represents about 3% of the cases in the U.S, but it has a doubling time of about three days. By comparison, the delta variant doubled at a rate of about two weeks.
“It is the most transmissible virus of Covid-19 that we’ve had to deal with thus far,” Fauci, who’s also the director of the National Institute of Allergy and Infectious Diseases, said about omicron.
South Africa has already been overtaken with the variant and the U.K. also expects the omicron variant to dominate soon. “If things go in the United States the way they’ve gone in other countries—and there’s no reason to believe that that won’t be the case—it will soon become dominant here,” he said. |
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