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Introducing HB 281: Enforcement of Federal Immigration Laws in Ohio Hospitals

Client Alert

On May 20, 2025, House Bill (HB) 281 was introduced in the Public Safety Committee. HB 281 seeks to require licensed hospitals regulated by the Ohio Department of Health (ODH) (per O.R.C. 3722) and licensed psychiatric hospitals regulated by the Ohio Department of Mental Health and Addiction Services (OMHAS) (per O.R.C. 5119) to permit law enforcement to enter hospital facilities and enforce immigration laws.

Law enforcement includes any agent or officer of the U.S. Department of Homeland Security (DHS), any other federal law enforcement officer, or any state or local law enforcement officer who is assisting a federal officer or agent of DHS (federal agents). When enforcing federal immigration laws, law enforcement would be permitted to (1) arrest any individual, including patients or family members present pursuant to a lawful judicial or administrative warrant; (2) interview any individual, including patients or family members present; (3) collect information or evidence, potentially including personal information or citizenship documentation; and (4) request hospital employees to provide any information or evidence that the hospital possesses to the extent permitted by federal or state law. If law enforcement is denied access to the hospital, the agent can file a report with the hospital’s respective Ohio licensing agency (ODH or OMHAS), which can cause the hospital to lose state funding and its status as a Medicaid provider.

Moving forward, HB 281 requires hospitals to adopt a written policy to establish standards and procedures to comply with law enforcement’s requests for information. Hospitals will need to think about how they want to structure their policies and procedures to comply with state law and also protect patients. HB 281 will dramatically impact hospitals’ ability to protect immigrant patients. One practical impact of HB 281 will be fewer patients, especially immigrant patients without legal status, seeking life-saving healthcare services at Ohio hospitals. Additionally, hospitals will be required to routinely deal with law enforcement while simultaneously providing care to patients.

To learn more about HB 281 and how the bill could impact your hospital, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.


New $100,000 Fee on H-1B Petitions – Legal Immigration

President Trump issued an Executive Order (EO) imposing a $100,000 payment to accompany any new H-1B visa petitions submitted after 12:01 a.m. eastern time on September 21, 2025 and will remain in place for 12 months (unless extended).

Implications of Supreme Court Stay for Business Operations in Noem v. Vasquez Perdomo

On September 8, 2025, the U.S. Supreme Court temporarily reinstated immigration officers’ authority to conduct brief stops based on factors such as location, work type, language, or appearance. This stay in Noem v. Vasquez Perdomo allows enforcement actions to resume in California pending appeal. Employers in industries like construction, agriculture, landscaping, and day labor should prepare for increased worksite disruptions and review compliance protocols.

Ohio House Bill 429: Potential Relief for Providers Facing Same-Day Reimbursement Restrictions

Ohio House Bill 429 aims to prevent third-party payers from reducing provider reimbursement for multiple procedures performed on the same day. The bill could improve payment practices for a range of specialties, including surgery and gastroenterology.

FTC Continues to Target Noncompetes

The FTC is intensifying its focus on noncompete agreements in healthcare, urging employers to review contracts for compliance. While Ohio still generally enforces noncompetes, pending legislation could limit their use.

Medicare Updates: Prior Authorizations and Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) has announced two key updates effective January 1, 2026: a six-state prior authorization pilot program targeting high-risk services under the WISeR Model, and proposed revisions to the Physician Fee Schedule (PFS) that include increased payment rates, expanded telehealth coverage, and updated policies for chronic care, behavioral health, and rural providers.