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FILE – In this May 19, 2021, file photo, a licensed practical nurse draws a Moderna COVID-19 vaccine into a syringe. (AP Photo/Steven Senne, File) Follow the federal government and risk a hefty fine, or follow the state and risk getting kicked out of the Medicare program and losing funding. In the middle of another COVID-19 surge, that is what health care systems are up against. A letter from the state’s health care administration is now adding even more pressure. Hospital systems like Lee Health and NCH need Medicare and Medicaid funding. Without it, they risk going out of business. “Being terminated from Medicare, Medicaid is not a risk that they’re willing to take,” said Meredith Plummer, an employment attorney with Gunster. When the Center for Medicare and Medicaid Services says all health care providers must impose a vaccine mandate, hospitals have little choice but to comply, but Florida’s Agency For Health Care Administration (AHCA) sent a letter saying not so fast. The letter says ACHA won’t help the federal government enforce its mandate. Good news for Florida health care providers, but if, for example, Lee Health demands the vaccine anyway, the letter says, “the attorney general’s office is authorized to impose administrative fines up to $10,000 per violation for an employer with fewer than 100 employees and up to $50,000 per violation for an employer with 100 or more employees.” Governor DeSantis has made it clear he will not accept hospitals firing doctors and nurses who choose not to get the shot. Plummer said, “we’re advising them, you know, while you’re preparing for these rules, you know, try to hold off on any employee terminations for the moment, because we do know that the Supreme Court is going to be hearing oral arguments on this issue.” The Supreme Court will eventually decide whether the federal mandate is legal. In a statement to WINK News, System Director of Strategic Communications for Lee Health, Mary Briggs wrote: As a community-owned health system, Lee Health is responsible for meeting the health care needs of our community. Over two-thirds of our patients are beneficiaries of Medicare or Medicaid. We must ensure that seniors and the vulnerable have access to health care services. Lee Health is closely monitoring the ongoing court cases as the courts attempt to work out the conflicts between state and federal laws. The United States Supreme Court will begin hearing arguments on the CMS mandate tomorrow. While we wait for clarity from the courts, Lee Health will follow the CMS regulations that are currently being enforced to ensure we can continue to provide access to quality health care for seniors and vulnerable individuals who rely on Medicare and Medicaid. NCH and Physicians Regional say they are in compliance with both federal and state regulations because they allow reasonable religious and medical exemptions. NCH did let some employees go who refused to be vaccinated. The Supreme Court could take weeks, or longer, to determine whether the federal vaccine mandate is legal. Until then, a lower court judge has given the Biden administration the OK to begin enforcing it. The mandate states that employees of health care providers must have at least one dose of the vaccine by January 27th.