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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.


Key Healthcare Provisions in Ohio’s 2026–2027 Budget

Ohio’s newly enacted biennial budget (HB 96) for FY 2026–2027 brings sweeping changes for healthcare providers across the state. The law includes new Medicaid eligibility requirements, reporting mandates, funding directives, and social policy provisions. Several vetoes by Governor DeWine also affect healthcare-related initiatives.

Providers Beware: Court Sides with Insurers in No Surprises Act Arbitration

On June 12, 2025, the Fifth Circuit ruled in favor of Aetna and Kaiser in two lawsuits brought by air ambulance providers challenging how insurers calculated payments under the No Surprises Act’s Independent Dispute Resolution process. The court held that unless there is clear evidence of fraud or serious misconduct, IDR decisions will stand, reinforcing the finality of the arbitration process.

Parental Consent May Soon Be Required for Minor Mental Health Services in Ohio

HB 172 proposes repealing a provision in Ohio law that allows minors age 14 and older to consent to limited outpatient mental health services without parental involvement. The bill would require parental consent for all such care and remove related language from other sections of the Ohio Revised Code.

Community Behavioral Health Providers - Supervisor Pricing Changes Begin July 1 [Corrected Date]

Effective June 16, community behavioral health providers wishing to receive reimbursement at the supervisor rate must add the HP or HT Modifier to fee-for-service (FFS) claims. Find out about the new guidelines.

CMS Rescinds EMTALA Guidance for Emergency Abortions

On June 3, 2025, CMS withdrew its 2022 guidance on emergency abortion care under EMTALA, eliminating federal protection for providers in states with abortion restrictions. This policy change could significantly impact how hospitals handle emergency care involving pregnancy complications.