Supreme Court Decides Fate of OSHA and CMS COVID-19 Mandates; What It Means for BH Providers

Updated: Jan 31

In November 2021, OSHA issued a federal rule mandating COVID-19 vaccinations or at least weekly testing for workers at U.S. companies with 100 or more employees. The administration also released a new rule through CMS requiring employees at health care facilities participating in Medicare or Medicaid to be fully vaccinated by January 4.


After two months of legal battles in which Ohio participated, both mandates came before the United States Supreme Court. The U.S. Supreme Court struck down OSHA’s vaccine-or-test rule, declaring that the Department had exceeded its authority over large businesses. At the same time, however, the high court upheld the CMS vaccine mandate for Medicare and Medicaid providers.


Many entities are listed as having to comply with the CMS mandate, including federally-defined CMHCs. However, to be considered a covered entity, an agency would have to do all of the following:

  • Provide outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically mentally ill, and residents of its mental health service area who have been discharged from inpatient treatment at a mental health facility;

  • Provide 24-hour-a-day emergency care services;

  • Provide day treatment or other partial hospitalization services, or psychosocial rehabilitation services;

  • Provide screening for patients being considered for admission to State mental health facilities to determine the appropriateness of this admission;

  • Meet applicable licensing or certification requirements for CMHCs in the State in which it is located; and

  • Provide at least 40 percent of its services to individuals who are not eligible for benefits under title XVIII of the Social Security Act (aka Medicare).

Entities performing all of the above services and who are certified as a CMHC through CMS, are subjected to the mandate.


New and updated tools and resources have been developed by CMS to help determine whether the vaccine requirements apply to you and your organization. Additionally, this infographic shows the phases and deadlines of the vaccination rule implementation state by state.