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New State Budget Institutes Licensure Requirement for Ohio’s Hospitals

Client Alert

On July 1, 2021, Governor Mike DeWine signed Ohio’s final budget codified at Ohio Revised Code 3722.01 et seq., which includes a new licensing requirement for Ohio’s hospitals.

For years, Ohio was the only state in the country that did not license its hospitals. This approach will now be replaced with new, detailed requirements that will require careful review and compliance. Here are some of the highlights concerning these new changes:

When will a license be required?

All hospitals operating in the state of Ohio will be required to be licensed with the Ohio Director of Health within three years of the effective date of the new budget.  “Hospital” is defined by the Act as any institution or facility that provides inpatient medical or surgical services for a continuous period longer than 24 hours.

Some facilities will be exempt from the new licensing requirement, including hospitals operated by the federal government, nursing homes, and facilities used exclusively for hospice patients.

How do you receive a license?

License applications will begin to be considered by the Director after the Act has been effective for one year. The following will be required to be eligible for a license:

  • A completed application submitted with the accompanying fee;
  • Title XVIII certification under the “Social Security Act” or accreditation from a national accrediting organization approved by the Centers for Medicare and Medicaid Services; and
  • A detailed breakdown of the number of beds available in the hospital.

An issued license will be valid for three years unless it is revoked or suspended, and a license can be renewed for additional periods of three years upon expiration.

What new policies will necessitate hospital compliance?

Upon issuance of a license, further steps must be taken by the institution to maintain compliance. First, the hospital must have a governing board that is tasked with overseeing the hospital’s management and control. Second, the hospital will be required to comply with rules adopted by the Director establishing health, safety, welfare, and quality standards for licensed hospitals. These rules are required to be provided to hospitals within one year of the effective date of the budget.

The new regulations also carry steep civil penalties for hospitals that fail to comply with their terms. The Director of Health may levy a $250,000 civil penalty against the hospital and fine the institution an additional $1,000 to $10,000 for every day the hospital operates without a license. If a hospital fails to comply with any of the Director’s rules, a civil penalty between $1,000 and $250,000 may be levied. The Director may also petition for injunctive relief in the proper Court of Common Pleas if an imminent threat of harm exists at a licensed hospital; a granted injunction can only be lifted after a showing that the harmful condition identified has been removed.

To learn more about these new, detailed regulations and to discuss any required changes to your current policies and procedures, please contact BMD Government Affairs Member and Lobbyist Victoria L. Ferrise (vlferrise@bmdllc.com – (330) 374-5184).


Corporate Transparency Act Update

The Corporate Transparency Act (“CTA”), with an effective date of January 1, 2024, is set to impose strict reporting guidelines on business owners throughout the country. The following provides a brief update on two aspects of the CTA ahead of its effectiveness next week.

The Second Wave of UnitedHealthcare's Prior Authorization Cuts Started in November

In August 2023, UnitedHealthcare released its plan to eliminate roughly one-fifth of its then-current prior authorization requirements. The first round of prior authorization cuts took effect on September 1, 2023. In that round, UnitedHealthcare eliminated the necessity for some prior authorizations for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plan members. The second and final round of prior authorization cuts began on November 1, 2023. The November 2023 Prior Authorization Cuts apply to the same plans as well as community plans (i.e., Medicaid managed care plans).

Legal Uncertainties Remain Following Passage of Issue 1 in Ohio

In the November 2023 General Election, Ohio voters passed Issue 1 which, among other things, “[e]stablish[es] in the Constitution of the State of Ohio an individual right to one’s own reproductive medical treatment, including but not limited to abortion”. Despite passage of Issue 1, questions persist about how its codification on December 7 affects previously passed legislation restricting abortion and related pending court cases.

NLRB Issues Final Rule on Joint-Employer Status

On October 26, 2023, the National Labor Relations Board (NLRB) issued its final rule on determining joint-employer status, departing from its prior 2020 standard. The final rule provides that two or more entities may be considered “joint employers” if each entity has an employment relationship with employees and if the entities share or codetermine one or more employees’ essential terms and conditions of employment. The final rule goes into effect on December 26, 2023, and will only be applied to cases filed after the effective date.

WEBINAR SERIES RECAP | Employment & Labor

BMD Partner and Co-Chair of the Employment & Labor Law Group, Bryan Meek, presented this four-part webinar series on trending topics in employment law.