Legislation and Regulation

CMS Proposes Influenza Vaccination Standard for Medicare/Medicaid Providers and Suppliers

On May 4, 2011, CMS published a proposed rule that would require certain Medicare and Medicaid providers and suppliers to offer all patients an annual influenza vaccination, unless medically contraindicated or unless the patient (or patient's representative or surrogate) declines vaccination.

The requirement would apply to the following entities: hospitals (all types that participate in Medicare); CAHs; rural health clinics; Federally Qualified Health Centers, and end-stage renal disease facilities. These providers and suppliers have been proposed because: (1) in each setting, the patient presents before health care providers with staff licensed to provide vaccination at the time and location of the encounter; and (2) all have ready access to equipment and storage appropriate for handling, controlling, and administering vaccines.

The proposed rule also would require the specified providers and suppliers to develop policies and procedures that would allow them to offer vaccinations for pandemic influenza, in case of a future pandemic influenza event for which a vaccine may be developed. CMS will accept comments on the proposal until July 5, 2011. CMS expects to adopt a final rule in the early fall of 2011 that would be in effect during the 2011-2012 influenza season.

Proposed Rule on Influenza Vaccinations Standard for Medicare/Medicaid Provider and Suppliers
Source: California Department of Public Health


Health facilities: influenza vaccinations (SB 1318 awaits Governor Brown's signature)

Beginning July 2013, SB 1318 will require each clinic and health facility to offer onsite influenza vaccinations to their employees and to require employees to be immunized against the flu. Those health care workers who decline vaccination are required to wear clinic or health facility-provided surgical or procedural masks during the flu season.

Health facilities: influenza vaccinations
Source: California Legislative Council


California's Mercury Law (AB 2943)

Effective July 1, 2006, restricts mercury content in vaccines approved for children under three years and women who are "knowingly pregnant" as follows:

  • Influenza vaccine: <1.0 microgram/0.5mL
  • All other vaccines: <0.5 microgram/0.5mL

This act was added Article 9 to Part 2, Chapter 3 of Division 106 of the Health and Safety Code (entitled Personal Health Care). Health and Safety Code Section 124172.)

Assembly Bill (AB) 2943. Mercury-containing vaccines.
Source: California Legislative Council


California Health and Safety Code effective January 1, 2007

By July 1, 2007, the department shall require that each general acute care hospital, in accordance with the Centers for Disease Control guidelines, take all of the following actions:
(a) Annually offer onsite influenza vaccinations, if available, to all hospital employees at no cost to the employee. Each general acute care hospital shall require its employees to be vaccinated, or if the employee elects not to be vaccinated, to declare in writing that he or she has declined the vaccination.


For more information: http://www.cdph.ca.gov/programs/immunize/Pages/CaliforniaHospitalInfluenzaLaw.aspx


Flu Shot Bill (AB 106)

Signed by the Governor June 28, 2011 and went into effect immediately.

Flu Shot Bill (AB 106) requires acute care hospitals to offer flu and pneumococcal vaccinations to inpatients prior to discharge.

Flu Shot Bill
Source: California Department of Health Services

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