Requires that hospitals and skilled nursing and intermediate care facilities participating under title XVIII (Medicare) or XIX (Medicaid) of the Social Security Act offer their employees who are at an occupational risk of exposure to blood borne viruses inoculation against hepatitis B virus without charge. Reduces, by ten percent, Medicare and Medicaid payments to hospitals and facilities which fail to make such inoculations available. Requires that such funds withheld from noncompliant hospitals and facilities be used to make grants to hospitals and facilities to fund hepatitis B vaccine purchases. Allows hospital and facility employees to exercise an informed choice not to receive such a vaccination.