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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.


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.

USCIS Policy Updates: Implications for Business Immigration

In August 2025, USCIS issued three key policy updates enhancing vetting, good moral character (GMC) evaluations, and scrutiny of "anti-American" conduct in immigration adjudications. These policy memos will impact employers sponsoring foreign workers, including H-1B, L-1, EB visas, adjustments, and naturalization.

Ohio Passes Antidiscrimination Provision for CRNA Reimbursement

Ohio has passed House Bill 96, introducing a provider nondiscrimination provision that requires health plans to reimburse certified registered nurse anesthetists (CRNAs) at the same rate as physicians for the same services. The law aims to improve patient access to care by eliminating payment discrimination against CRNAs and will take effect on September 30, 2025.

Ohio Board of Pharmacy | Administrative Code Rule Changes

The Ohio Board of Pharmacy (“BOP”) recently posted notices of Ohio Administrative Code rule changes related to record keeping and the sale and distribution of certain ephedrine-containing products.