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OAAPN | Year In Review: 2026 Ohio Board of Nursing and Ohio Law Rules

Client Alert

Originally published by Ohio Association of Advanced Practice Nurses (OAAPN)

February 9, 2026

As 2026 charges forward, we want to highlight key changes to Ohio law and the Ohio Board of Nursing rules that have directly impacted APRN practice over the past year (and a little beyond that).

Psychiatric Inpatient Documents

Effective September 20, 2024, Senate Bill 81 gave APRNs the ability to sign documents related to the admission, discharge, and treatment of psychiatric inpatients. To be eligible to sign these documents, the following must be met:

  1. The APRN must be employed by or have credentials at the facility;
  2. The APRN’s collaborating physician is employed by or is a medical staff member at the facility;
  3. The APRN’s collaborating physician has authorized the APRN to sign these documents for the physician’s patients; and
  4. This authority is set forth in the APRN’s standard care arrangement.

Intimate Examinations

Senate Bill 109 became law at the end of 2024 to enhance the safety of Ohio patients. As it pertains to the practice of nursing, the law prohibits RNs, APRNs, and nursing students from performing an intimate examination on an anesthetized or unconscious patient, absent an exception. For example, the prohibition does not apply when a patient or their legal representative has given specific, informed consent for the intimate examination, consistent with the procedure set forth in ORC 4723.93(D).

Signature Authority

We kicked off 2025 celebrating the passage of Senate Bill 196, also known as Global Signature. As a result of Global Signature, APRNs may now sign and complete certain paperwork associated with patient care within their scope of practice. APRN signature recognition extends to several different patient care forms including certification of disability for patients to receive disabled parking placards and patient orders for life-sustaining treatment (POLST) and other end-of-life care documents. Although APRNs are still not permitted to sign death certificates, Global Signature expanded a CNS’s, CNP’s, and CNM’s authority to determine and pronounce an individual’s death. APRNs may also now develop protocols and authorize pharmacists to use such protocols for dispensing nicotine replacement therapy and epinephrine. While we continue to advocate for greater APRN signature authority, Global Signature was a positive step for both APRNs and patients across the state.

Duties Related to Fetal Death

Senate Bill 196 also established a new provision in the Ohio Nurse Practice Act related to fetal death. If a woman presents herself to a CNM, CNS, or CNP as a result of experiencing a fetal death, and the woman is not referred to a hospital, the APRN must provide the woman with the following:

  1. A written statement, not longer than one page in length, that confirms that the woman was pregnant and that she subsequently suffered a miscarriage that resulted in fetal death;
  2. Notice of the right of the woman to apply for a fetal death certificate;
  3. A short, general description of the nurse’s procedures for disposing of the product of a fetal death.

A copy of the written statement and documentation that the requirements listed above were provided must be documented in the woman’s medical record.

-->You can access the full article at this OAAPN LINK for a review of these additional areas:

  • Retail IV Therapy Clinics
  • Release from Permanent Restrictions
  • Disciplinary Action
  • Course on Drugs and Prescriptive Authority
  • Overdose Reversal Drugs
  • Office Based Opioid Treatment
  • Withdrawal Management for Substance Use Disorder
  • Safe Haven Program
  • House Bill 508 - Proposed Retirement of the SCA
  • House Bill 52 - CRNA Practice Revisions
  • House Bill 337 - Laser Hair Removal
  • House Bill 537 - Midwife Bill

If you have any questions about how these change impact your practice, please contact BMD Health Law Member and OAAPN General Counsel, Jeana Singleton at jmsingleton@bmdllc.com.


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.

Ohio Department of Medicaid Updates: Key Changes to Physician Reimbursement Rates in Early Parenthood

The Ohio Department of Medicaid has proposed amending Ohio Administrative Code Rule related to covered Medicaid reimbursements for physicians. Beginning on January 1, 2026, they are proposing an increase to rates for prenatal care, childbirth, and infant care and provider visits.