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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.


January 2025 Notice of Proposed Rulemaking Brings Notable Changes to HIPAA Security Rule

In January 2025, the U.S. Department of Health and Human Services proposed amendments to the HIPAA Security Rule, aiming to enhance cybersecurity for covered entities (CEs) and business associates (BAs). Key changes include mandatory compliance audits, workforce training, vulnerability scans, and risk assessments. Comments on the proposed rule are due by March 7, 2025.

Corporate Transparency Act Effective Again

The federal judiciary has issued multiple rulings on the enforceability of the Corporate Transparency Act (CTA), which took effect on January 1, 2024. Previously, enforcement was halted nationwide due to litigation in Smith v. U.S. Department of the Treasury. However, on February 18th, the court lifted the stay, reinstating the CTA’s reporting requirements. Non-exempt entities now have until March 21, 2025, to comply. Businesses should act promptly to avoid civil penalties of $591 per day and potential criminal liability.

Status Update: Physician Noncompete Agreements in Ohio

Noncompete agreements remain enforceable in Ohio if they meet specific legal requirements. While the AMA and FTC have challenged these restrictions, courts continue to uphold reasonable noncompete provisions for physicians. Recent cases, like MetroHealth System v. Khandelwal, highlight how courts may modify overly restrictive agreements to balance employer interests with patient care. With ongoing legal challenges to the FTC’s proposed ban, Ohio physicians should consult a healthcare attorney before signing or challenging a noncompete agreement.

Immigration Orders and Their Economic Impact on Small Business: Insights from Attorney and Former Immigration Judge Rob Ratliff

President Trump's recent executive orders, targeting immigration policies, could significantly impact small businesses in Ohio, particularly those owned by undocumented immigrants. With stricter visa vetting, halted refugee admissions, and potential deportations, these businesses face uncertainty, workforce disruption, and closures. Ohio's immigrant-owned businesses, especially in food services and transportation, contribute billions to the state economy, and any disruption could result in economic ripple effects.

Corporate Transparency Act Ruling from the U.S. Supreme Court

The U.S. Supreme Court recently ruled on the enforceability of the Corporate Transparency Act (CTA), lifting an injunction previously imposed by the Fifth Circuit. However, a separate nationwide injunction remains in effect, meaning businesses are still not required to comply with the CTA’s reporting requirements. FinCEN continues to accept voluntary reporting while enforcement remains paused.