Mask requirements remain in half of medical groups three years into COVID-19

As the world approaches the three-year anniversary of the COVID-19 pandemic declaration and the looming end of the public health emergency (PHE) in the United States, several healthcare organizations are doing away with the most visible signs of the upheaval created by coronavirus: mask rules.

The shift away from mask requirements in healthcare facilities has been swift in the past week:

• In late February, two major Colorado health systems — UCHealth and Denver Health — announced they would no longer require masks.
• In the past week, Utah-based Intermountain Health said most of its mask rules would be reversed as of March 15 across facilities in multiple states, with the exception of surgical procedures and other unique cases.
• Health authorities in Oregon and Washington State also announced a plan to lift masking requirements for healthcare facilities as of April 3.
• The California Department of Public Health has similar plans to remove mask requirements in high-risk health settings as of April 3, as well as an end to its healthcare worker vaccination requirements.

A March 7, 2023, MGMA Stat poll gives a real-time picture of the mask requirement landscape: About half (49%) of medical groups reported having some type of mask requirement in place, versus 51% that do no not. The poll had 859 applicable responses.

• Among the medical groups that reported not having a mask requirement, 74% of them indicated they had one in place at this point in 2022 and removed those rules in the past year, whereas the other 26% had either previously removed such policies or never had one.
• Among the 49% of groups that still have mask requirements, many vary based on who must don them and in which settings:
  • 72% of respondents said their policies applied to everyone — staff, patients and visitors — while about 1 in 5 (20%) said policies applied only to symptomatic patients and the staff/providers working with them, while about 8% had mask rules for exclusively for staff but optional for patients and visitors.
  • In terms of where policies applied, only 31% of respondents noted that masks were required throughout the entire facility. The majority (63%) have mask requirements that apply in limited areas (e.g., public/patient-facing areas or clinical areas), while 6% had some other criteria, such as:
    • Certain areas always requiring a mask (e.g., surgery centers and chemotherapy rooms) while others had no mask requirements
    • Conditioning mask rules on COVID-19 community transmission rates
    • Seasonally implementing masks during cold and flu season.

It’s likely that the share of medical groups with mask requirements will continue to decline in the weeks ahead, as several respondents told MGMA that they are located in one of the West Coast states set to drop government-mandated mask rules as of April 3.

How COVID-19 mask rules evolved

These figures show an update from previous MGMA Stat polls that revealed:

• About 32% of medical groups did not require masks for anyone five months ago, according to results of an Oct. 4, 2022 poll, which also found that nearly 6 in 10 (57%) groups still required masks for everyone, and about 11% had rules that required masks only for certain people in certain settings.
• Two-thirds (66%) of medical practices had not relaxed their mask policies at this time last year, per a March 11, 2022, poll.
• An April 2022 court ruling that overturned the Centers for Disease Control and Prevention (CDC) rule to require masks on public transportation helped set off a flurry of questions from the public about whether mask rules were still valid in healthcare facilities, per an April 26, 2022 poll.

Navigating to a post-PHE landscape in healthcare

In February, the Biden Administration announced the final extension of the COVID-19 PHE, with an end date of May 11, 2023. The move provided 90 days’ notice — as MGMA advocated — as opposed to the 60 days’ notice that was previously offered for previous renewals of the declaration. Under the PHE, the Department and Health & Human Services (HHS) had authority to waive certain program requirements, though many of those flexibilities will expire after May 11.

“The impact will vary based on state, patient and payer mix. Fortunately, Congress addressed most of the critical Medicare telehealth waivers in recent legislation (Consolidated Appropriations Act, 2023) by extending these waivers through 2024, which provides some predictability for practices,” Claire Ernst, director of MGMA Government Affairs, told Health Exec in February. “It also gives the administration and Congress more time to gather data regarding telehealth utilization, quality outcomes and cost.”

MGMA Government Affairs recently updated the member-benefit resource on Medicare telehealth waivers, which addresses payment policies that were impacted for the duration of the PHE. Practice leaders should pay close attention to commercial payer rules separately, as some have their own rules that do not align with Medicare policy.

Additional resources

• HHS Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap
• HHS overview of telehealth policy changes post-PHE

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