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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. 


Ohio Recovery Housing Operators Beware: House Bill 58 Seeks to Make Major Changes

Ohio House Bill 58 proposes significant changes to recovery housing oversight, granting ADAMH Boards authority to inspect and investigate recovery residences. The bill also introduces a Certificate of Need (CON) program, requiring state approval for major facility changes. OMHAS will assess applications based on cost, quality, accessibility, and financial feasibility. The bill also establishes a recovery housing residence fund to support inspections. For more information, contact BMD attorneys Daphne Kackloudis or Jordan Burdick.

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.