Blog, Chirosecure Live Event September 29, 2021

Are Vaccines Mandatory for Chiropractors?

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Hi everyone. This is Sam Collins, your coding and billing expert for chiropractic and the HJ Ross company, bringing you another episode of ChiroSecure’s Growth Without Risk. We’re going to discuss what’s going on with vaccines. The mandates what’s required. What’s not required who can mandate it and what do we have to do? So let’s go to the slides and let’s figure out what’s happening. Obviously we’ve heard a lot about mandatory vaccines and what are the requirements for a chiropractic provider? However, are there going to be some variances and differences? So let’s move ahead here. Who can mandate you to do a vaccine? Well, obviously there’s a lot of entities or several. Anyway, it could be the government and that government could be whether it’s federal, state or local, you know, so it could be a county or a city, but it can also be a private business.

So those actually can in fact, take a look at this law and you’ll notice here there is misinformation. What I call misinterpretations that people always do at July six, the office of legal counsel of the United States department of justice issued a legal opinion stating that federal and state governments were not prohibited by federal law from imposing vaccine mandates. So in other words, yes, they can. We can argue all types of things, but the federal government has come in and said, what’s the Supreme court office of inspector general that they may. So let’s move from here. And let’s talk about on the federal level with Medicare, because there was a lot of misinformation. And one thing I want you to be clear on, always make sure you’re getting your information from the correct source, not hyperbole. So this is what Medicare said. Joe Biden president of course made a vaccination mandate for anyone that was Medicare and Medicaid certified, but it said facility.

So you’ll notice here. It says facilities across the United States should make efforts now to get their health care staff vaccinated. So everyone says, well, what does that mean? Chiropractic? Are we considered facilities? Well, you’re probably all familiar with Medicare. Isn’t there a facility fee different from a physician’s fee. There is so let’s look further. Facilities are defined as any provider, such as a hospital, nursing facility, home health agency, outpatient physical therapy, which means it looks like it includes everyone. So you’re thinking, well, are we considered a facility? And that’s where a lot of the misinterpretations come from. So what we have now of course is chiropractors can be part of a facility if you will, if you think of it, we’re part of that structure and you can be registered with Medicare as par or non-par. You could of course not register with Medicare, but I want to be careful here.

If you’re not registered with Medicare, you wouldn’t have any mandate at all, because obviously you can’t see Medicare patients. It’s only if you can see them. Let’s remember chiropractors can not see Medicare patients if you’re not registered at least for chiropractic manipulation. Well, with all that said, let’s move ahead and talk about what really occurred. The new mandate for Medicare facility providers, such as hospitals and skilled nursing facilities. It does not include fee for service providers, including private offices. And this is often there’s misinterpretation. The term facility often means a facility, meaning like a hospital or large type clinic, inpatient almost. If you will. In fact, the CMS suppose spokesperson last week clarified this regulation that does not directly affect or apply to physicians offices as these are not regulated under the providers specific Medicare health and safety regulatory provisions referred to as conditions of participation.

So in simplest terms, chiropractors are exempt. There is no Medicare mandate for chiropractors to be vaccinated nor to have any of your staff. So from a pure federal Medicare standpoint, federal standpoint, not occurring. Well, what about some other federal? The VA came out with a statement a few weeks ago that it made it appear that everyone had to be mandated as vaccine. Even if you’re doing so-called VA choice or the so-called out of the VA hospital care with patients. And I’m sure many of you are registered, whether it’s with tri west or Optum. And of course, when you read this, it looks like it expanded to include chiropractors. The difference was it’s within the facilities. So let’s move ahead here and you’ll see here what it states it is not requiring community providers in their network to be vaccinated. If you were working in a VA facility in the VA hospital, the answer would be yes, but assuming you’re working just out of your office as a community care provider, it is not mandated.

So if you’re doing try west or, um, or Optum, this is not a requirement. So again, from a federal standpoint, there not been a mandate that would include chiropractic offices. So Medicare nor VA has gone that route. However, we have to deal with what is going on with different states. So I’m going to give you some examples here. The state of California did make a mandate that it appeared that the department of health issue, that everyone has to have vaccinations in doctor’s offices. Of course, often you have to say, well, who’s defining or what is a doctor’s office. So they made further clarification that this has exemptions, which include acupuncture offices, but also chiropractic offices. These facilities are not required. So this includes individual offices, really, whether you’re a chiropractor or otherwise, you’ll see here as acupuncture, office chiropractic, naturopath, occupational therapy, optometry offices, you know, outpatient, physical therapy.

And of course, including pharmacies and get this even further podiatry as well as if you’re working in a first date, in a resort or a theme park. So if you work at Disneyland, doesn’t apply really, this means it’s kind of doing the same thing. It’s not mandating it for individual offices, chiropractors, specifically being exempted. Now does that exempt everyone? I still think that under medical offices, you’ll notice here. It’s there, but for chiropractic offices, the answer is no. Well, let’s take a look at what about some other states? Well, New York has come out. In fact, they’ve mandated for October 1st that there has to be.

So you’ll see here, they’ve appointed on August 26, that it improve a broad regulation that mandated vaccines for all health care facilities. The difficulty comes in who defines or what is the facility? Well, this regulation says that for a licensed healthcare providers licensed in New York. So when you read through this, it says general hospitals and nursing homes. It goes further to indicate diagnostic and treatment centers, including without limitation, community health centers, federally qualified birth centers, rehabilitation clinics. And along with that, you’ll notice here a certified home health agencies and so forth. What you’ll notice though, is none of this really indicates anything that would be interpreted under chiropractic, even home and inpatient hospices. So at this point, it does not determine to be chiropractors. I would still stay on top of this to make sure there isn’t further interpretation, but I’ve seen nothing that would indicate that a chiropractic office would be included within this.

And you’ll notice all the listings of one here all the way through adult care facilities really doesn’t match a chiropractic office. However, that’s New York and California. What about the state of Washington? So this is Washington state, Washington state made a mandate, you know, back in August that everyone has to have it by October 18th. It’s important now to kind of think this through, because October 18th means if you’ve not been vaccinated, you have a very short time because you have to get the second one, two weeks later, are you going to have enough time? And so under their mandate, it says it requires operators of any healthcare setting to have a vaccination status. And this is going to include every employee volunteer contractor. So this means everyone in your office, if you’re licensed under Washington law. So this means employees, volunteers, anyone in your office, including the doctor and chiropractors are not exempt from this.

You are included in this mandate. This is going to be very complicated for some doctors, of course, who have a very strong feeling about whether they can or can’t. My concern would be how they’re going to enforce it. Will they be sending out to all licensees, a request to show vaccination status? And if you’re not, then you can’t practice that to me would seem probably the simplest, but they’re putting a lot of pressure here. And I think you may want to rethink is your practice worth, or are you going to die on the vine over not vaccinating to lose your practice? If this pushes, of course there can be lawsuits in there, but is that something we have the money or time to do? There are some exemptions, the exemptions, if you’re unable to get vaccinated because of a disability, obviously, or if you’re the type that can’t get, or if you have a sincere held religious belief, the difficulty with the religious belief is what religion who’s going to state it.

You have to be able to give something that makes it for real, if you will. So again, I’m not sure how far they’re going to go with that, but I would be careful. I would say Washington has taken a very strict role. Then it says if an individual does not qualify for an accommodation, they must get vaccinated. And testing is not an alternative. So they’re really pushing back quite hard in Washington. And I’ve had a lot of providers who have been up in the air and I’ve, I’ve kind of down to, you’ve got a successful practice. Is this the type of item you want to potentially risk your entire practice over? And again, for some I know that’s going to be true. So certainly you want to be working immediately with an attorney or someone because if not potentially, could they close your practice down if you don’t comply by the 18th?

It’s certainly possible. I don’t think probably reasonable under that short time, but again, I don’t want to take that risk. So Washington, yes, New York, California saying no exemptions. What about some other states? Well, Oregon has made the same thing October 18th, and this is an effect for chiropractic offices. And just for them the same thing, there’s going to be no alternative for testing. What about other states though? So these are the states. I do have information on Rhode Island, Illinois and Washington, DC are mandating. I didn’t see any rules for exemptions outside of probably maybe religious and likely going to be obviously if you have a health status or otherwise Colorado made a rule also, but chiropractors are exempt. The difficulty here is understanding what your rules are. So I would make sure in any state you’re in verify your state. Is there a requirement? And if not, what are the, or if there is, are there any exceptions, might you fit into those or would it be something that you just simply have to be vaccinated?

What about other people in your office? This is becoming a very hot button item, but you want to make sure I’m going to keep your practice open. I want to make sure you can help the patients that need your help. And again, if this is something that’s that important to you, certainly something to look into. Is there any way to be exempted? Most of these are not allowing any testing, so it’d be very conscientious for your practice. What’s going on, check with your state check with your local. Cause there could be differences for your city or county. For the most part, it appears outside of these. There’s probably going to be exemptions, but don’t assume all take a look. Now you might wonder, where am I going to get this? Who else can mandate this? Well, local employers according

And the legal experts, a private employer can mandate a vaccine. Remember employment is at will. And if you don’t follow certain aspects, they could fire you for pretty much, any reason. So keep in mind again for an employee. And I’ve noticed this in New York, there’s a lot of schools. Well, not a lot, but several school teachers who have said, well, they’re not going to do it. Which means they’re just simply losing their jobs. So that’s like, wow, that’s, that’s a big issue. So a local employer, can, you might wonder how can they force me to do that? Well, I’ll give an example here. Does Disney allow their employees to have facial hair? If you’re not aware of that Disney company had always banned any type of facial hair the entire time they were open because they had a very clean cut. Look now, to me, that was kind of funny because Walt himself actually had a mustache, but if you work for him, you couldn’t.

So you could not have any type of facial hair up until recently. Facial hair is now allowed since 2012, but it must be as they state allowed to have beards, as long as they’re kept short and trim. So could an employer make a difference that you have to wear certain clothing? So realize there’s going to be a certain level of power that you would have as an employer. If an employee doesn’t want to, then they might lose their job. Same as here. So realize there’s a lot of areas here that we don’t have as many rights as people think for everything. There’s obviously going to be public health things, wearing a seatbelt or being a stop sign for that matter. So where are you going to get this type of information while a couple of things you’ll notice here, I brought up the HJ Ross website and you’ll notice here.

This is our new section. And in the red section here, you’ll notice I have federal vaccine mandates do not include chiropractic offices or providers. Now that’s a very broad statement that was sent out to all our members about two weeks ago, even if you’re not a member, go to our site subscribe so that you’re updated with this news. You’ll read the latest updates to it. What’s going on with mandates and I will update as it comes out, but make sure you’ve got a trusted resource. Remember, Google is not always your friend when it comes to these topics because there’s a lot of people who might write something, but don’t have the actual laws or regulations, by the way, what’s going to begin this Friday, October 1st, if you’re not aware the diagnosis codes making updates specifically for back pain. So take a look here. I put it in blue here and update for back pain, ChiroSecure the HJ Ross company.

We’re always here to be a support place for you. Where are you going to get your information? Where are you going to make sure your practice can do well? Will the HJ Ross company we’re always here. We do continuing education courses. We also offer a service where I can help you. One-on-one what I want to say is, do you have someone on your team? That’s doing the work behind the scenes for this type of thing. You’re a good doctor, but do you have all the time to do all this stuff? Allow us to be that person, HJ Ross, company and seminars are here for that. As well as ChiroSecure. I’m going to say best wishes to all of you. I wish you much success, but I will say always stay on top of what’s going on. What’s changing because your practice is important and you’re important to me. So I want to make sure you’re doing well. Always go to our website, reach out to me, reach out to ChiroSecure. We’re always here to help. Thank you everyone. See you next time.