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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).


Preventing a Board Investigation

Healthcare professionals in Ohio are subject to licensing board investigations that can lead to disciplinary action. Staying compliant with regulations, documenting carefully, and operating within your professional scope can help prevent issues. If contacted by a board, working with an attorney is critical to protect your license and rights.

Ohio Board of Nursing Proposes Rule Changes for Nurses

On Monday, January 12, 2026, the Ohio Board of Nursing (“BON”) released a package of proposed changes to the Ohio Administrative Code. There are two proposed changes to continuing education requirements that Ohio nurses should be watching.

New Florida Law: Patient Overpayments Must Be Refunded Within 30 Days

Effective January 1, 2026, Florida Senate Bill 1808 requires health care facilities and practitioners to refund patient overpayments within 30 days after an overpayment is identified. The law applies to overpayments tied to claims submitted to government programs or private insurers and introduces fines and disciplinary consequences for noncompliance. Providers should review billing and payment practices now to prepare for the new requirements.

USCIS Policy Change Impacting Work Authorization: Advisory for Employers and Human Resources

USCIS has issued a policy memorandum pausing immigration benefit processing for individuals from 19 high-risk countries and requiring a re-review of certain previously approved cases. This change may affect work authorization, employment verification, and workforce stability. Employers and HR teams should review impacted employees and update compliance procedures.

CMS Releases CY 2026 Medicare Physician Fee Schedule Final Rule with Key Payment and Telehealth Updates

CMS issued the CY 2026 Medicare Physician Fee Schedule Final Rule on October 31, 2025, with changes effective January 1, 2026. The Final Rule includes increases to the conversion factor, a new efficiency adjustment, updates to practice expense methodology, permanent telehealth policy changes, revised payment for skin substitutes, expanded rules for Part B drugs and biologicals, enhanced policies for Rural Health Clinics and Federally Qualified Health Centers, and new care management and behavioral health services.