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New Federal Medical Conscience Rule and Its Implications

Client Alert

New Statutes offer health care providers (and payors) protections against recipients of federal funds when refusing to provide services based on religious or moral grounds. The federal health care conscience protection statutes (the “Statutes”) include, among others, the Church Amendments, the Coats-Snowe Amendment, the Weldon Amendment, and certain Medicare and Medicaid provisions.

The Department of Health and Human Services Office for Civil Rights (OCR) issued a Final Rule regarding these Statutes on January 11, 2024 (effective March 11, 2024), clarifying the provisions, which gives the OCR the authority to receive, handle, and investigate complaints under the federal health care conscience protection statutes.

Services that are typically protected under the Statutes include assisted suicide, abortion, and sterilization. Importantly, providers cannot provide services to some patients and not others. Additionally, it is important to note that the protections apply to services/procedures – therefore, a provider cannot refuse to provide a service to a particular person or group of people based off of religious or moral beliefs.

Authority of the OCR in enforcing the Statutes includes:

  • Receiving and handling complaints;
  • Initiating compliance reviews;
  • Conducting investigations;
  • Consulting on compliance within the Department;
  • Seeking voluntary resolutions of complaints;
  • Consulting and coordinating with the relevant Departmental funding component and utilizing existing enforcement regulations, such as those that apply to grants, contracts, or other programs and services;
  • In coordination with the relevant component or components of the Department, coordinating other appropriate remedial action as the Department deems necessary and as allowed by law and applicable regulation; and
  • In coordination with the relevant component or components of the Department, making enforcement referrals to the Department of Justice.

When investigating potential violations of the Statutes, the OCR may review the practice’s policies, communications, documents, and compliance history. The OCR states that matters will be resolved via “informal means” whenever possible, but if not, the OCR will coordinate and consult with the Department responsible for the relevant funding to undertake appropriate action. The OCR may also refer the matter to the Department of Justice. It is important for entities to respond promptly to the OCR’s investigation and to keep adequate records.

In addition, the OCR encourages all entities subject to the Statutes to post a “model notice” in a prominent and conspicuous location to notify both providers and patients of their compliance. The model notice provided by the OCR can be found here.

Entities should also consider updating their policies and procedures to include the protections under the Statutes. For example, entities may include a statement that providers will not be required to participate in, and will not be discriminated against, for refusing to participate in specific medical procedures and related training and research activities or coerced into performing procedures that are against their religious or moral beliefs. Such procedures should also provide the steps providers can take to invoke their rights under the Statutes.

If you have any questions regarding the Final Rule, please don’t hesitate to contact BMD Health Law Group Member Jeana M. Singleton at jmsingleton@bmdllc.com or 330-253-2001, or BMD Attorney Rachel Stermer at rcstermer@bmdllc.com or 330-253-2019. 


Quiet Hours Texts and TCPA Claims: Consent Remains King as Courts Divide on Text Messages

Businesses face increasing TCPA lawsuits over off-hours marketing texts, but recent court decisions highlight strong defenses. Clear consumer consent and updated terms and conditions can defeat many claims, while a growing number of courts are finding that text messages are not “telephone calls” under the statute. Proactive compliance measures, including clickwrap agreements and forum-selection clauses, are critical to reducing risk.

New Ohio Reporting Requirements for Non-Residential Contractors

Ohio’s E-Verify Workforce Integrity Act, effective March 19, 2026, requires all nonresidential construction companies, subcontractors, and labor brokers to use E-Verify to confirm employee work eligibility on projects across the state. The law applies regardless of company size and carries financial penalties and potential restrictions on future state contracts for noncompliance. Some uncertainty remains around requirements for existing employees, making early compliance planning important.

DOT Non-Domiciled CDL Rule

A new rule from the Federal Motor Carrier Safety Administration (FMCSA) will significantly narrow eligibility for non-domiciled Commercial Driver’s Licenses (CDLs) beginning March 16, 2026. The rule limits eligibility to holders of H-2A, H-2B, and E-2 visas and eliminates Employment Authorization Documents (EADs) as qualifying proof of work authorization. As a result, many lawfully present and work-authorized immigrants, including refugees, asylees, DACA recipients, and Temporary Protected Status holders, will no longer be able to obtain or renew a non-domiciled CDL. The change is expected to affect roughly 194,000 drivers nationwide and has prompted multiple legal challenges, including a pending emergency stay request before the United States Court of Appeals for the District of Columbia Circuit.

FinCEN Residential Real Estate Reporting Rule Now in Effect

FinCEN’s new Residential Real Estate Reporting Rule, effective March 1, 2026, requires certain real estate transfers to be reported to combat financial crimes. Transfers of residential property to entities or trusts without financing may require a Real Estate Report.

Department of Education Proposes Redefinition of “Professional Degree,” Excluding Nursing and Limiting Graduate Loan Borrowing

The U.S. Department of Education has issued a Notice of Proposed Rulemaking that would redefine “professional degree” programs under the One Big Beautiful Bill Act. The proposal excludes nursing from the recognized list and would impose new borrowing limits for graduate students while eliminating the Grad PLUS program. Public comments are due by March 2, 2026.