End of Federal Public Health Emergency and State of Illinois Disaster

Proclamation on May 11, 2023 – CMS Issues Updated Guidance

May 4, 2023


On May 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued updated guidance on the end of the federal Public Health Emergency (PHE). Although the guidance is directed to state survey agency directors, IHA members should review the memorandum because it provides important details about waivers and other temporary flexibilities that will expire with the end of the PHE, scheduled for May 11, 2023.

Among other things, CMS stated it would “soon” end the requirement that covered providers and suppliers establish policies and procedures for staff vaccination, saying it will share more details on May 11 related to the elimination of this requirement. CMS has codified this vaccination requirement as a Medicare Condition of Participation; thus, it will likely require formal rulemaking to eliminate. The State of Illinois allowed its vaccination mandate for healthcare workers to expire in October of 2022 (with certain exceptions for employees of state-owned or state-operated facilities, but even those exceptions are set to expire on May 11).

CMS also reminded inpatient providers, including hospitals, about its regulations for Emergency Preparedness (EP) that require the provider/supplier to conduct exercises to test their EP plan to ensure that it works and that staff are trained appropriately about their roles and the provider/supplier’s processes. Hospitals should be prepared to comply with these EP regulations, including conducting any required exercises in 2023.

Finally, CMS provided updates to the expiration of waivers generally applicable to all hospitals, as well as waivers specific to critical access hospitals (CAHs). The expiration of waivers that are generally applicable to all hospitals pertain to requirements related to the Emergency Medical Treatment & Labor Act (EMTALA), verbal orders, discharge planning, medical staff, physical environment, medical staff, telemedicine, Quality Assessment and Performance Improvement Programs (QAPI), expansion sites, and swing beds. Waivers specific to CAHs that are also scheduled to expire, pertain to requirements related to personnel qualifications and staff licensure, status and location, length of stay, and physician oversite responsibilities.

IHA previously issued a memo on March 3 that outlined federal and state information pertaining to the end of the PHE. IHA also issued a memo on April 11 providing guidance on the termination of the national emergency with President Biden's signing of H.J. Res. 7. IHA will continue to track the impact of the expiration of the federal PHE and the state Disaster Proclamation and will provide links to these resources and other related information on IHA’s COVID-19 PHE sunset webpage.

Contact us with questions about the end of the PHE/Disaster Proclamation.