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CLIENT ALERT: Ohio Managed Care Organization (MCO) Open Enrollment

Client Alert

Open Enrollment started April 30, and will continue through May 25, 2018, for your MCO (Managed Care Organization).  Every State Fund Ohio employer can select their MCO for the coming policy year.  The MCO is responsible for helping to manage Ohio Workers’ Compensation claim costs.  All State Fund employers will begin to receive correspondence urging them to select that particular MCO, or urging them not to make a switch.               

 

Legislation introduced in 1993, which eventually became law after amendments, made managed health care a part of the Ohio Workers’ Compensation system.  That system has evolved over the years, and MCOs now make initial decisions involving most medical management issues in state fund claims.  Their importance cannot be overstated, as the medical management often dictates the path a particular claim will take.  It would be a mistake for any State Fund Ohio employer to simply allow the “default” MCO manage their claims.  Instead, they should examine their MCO (every State Funded employer has one – and if the employer has not selected one, then one is selected for that employer at random), and decide whether they want to switch or keep their MCO.

 

The Ohio BWC provides helpful information for those looking for basic information (which can be found at https://www.bwc.ohio.gov/downloads/brochureware/brochures/MCOGuide.pdf).  Of course, anyone who wants to discuss their overall claims situation is free to contact Richard Williger, and I’d be happy to spend some time looking at their overall Experience.


Name, Image, and Likeness Agreements in Healthcare

For example, some healthcare providers have begun to utilize "Name, Image, and Likeness" agreements to promote the brand they have created through their healthcare practice.  We have seen the most healthcare NIL activity with longevity and wellness providers, as well as orthopedics.

Compounding GLP-1 Drugs - Recent Updates

Recent guidance from the Ohio Board of Pharmacy (“BOP”) indicates that providers should generally use the FDA approved GLP-1 drug, rather than a non-FDA approved compounded version of the medication. Importantly, if a GLP-1 drug is commercially available, it cannot be copied through compounding. Currently, compounded copies of Tirzepatide and Semaglutide are not permitted.

Top Compliance Risks for Ohio Med-Spas in 2025

The Ohio Board of Pharmacy has increased inspections of med-spas holding Terminal Distributor of Dangerous Drugs (TDDD) licenses, with many facing enforcement actions in 2025. Common issues include purchasing from unlicensed distributors, improper drug storage, inadequate recordkeeping, and insufficient prescriber oversight. Understanding these risks and maintaining compliance can help protect your practice from penalties and license suspension.

Pre and Postnuptial Agreements | Necessary, Maybe, What Happened to Forever?

Both Florida and Ohio now allow clients to enter into a prenuptial or postnuptial agreement prior to marriage or after marriage (Ohio previously did not allow postnuptial agreements). Both documents have statutory guidelines that must be followed in terms of execution and financial disclosure.

DHS Ends All Employment Authorization Auto-Extensions

Effective October 30, 2025, DHS ends all automatic work authorization renewals. The 540-day extension applies only to renewals filed before this date, and there is no grace period for expired EADs filed on or after October 30. Employers must audit EADs, train staff, ensure I-9 compliance, and plan for work authorization gaps. Penalties for noncompliance can be severe.