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Parental Approval Mandate for Diagnosing Gender-Related Conditions in Minors under Ohio House Bill 68

Client Alert

Effective August 6, 2024, mental health professionals cannot diagnose or treat a minor presenting with a gender-related condition without first obtaining consent from one of the minor's parents, a legal custodian, or a guardian. The law, established by Ohio House Bill 68 (HB 68) and recently upheld by a Franklin County Common Pleas Court judge, imposes stringent requirements on the process that must be followed in these cases.

This mandate applies to a wide range of professionals, including advanced practice registered nurses (APRNs) specializing in psychiatric-mental health, psychiatrists, psychologists, licensed social workers, counselors, and marriage and family therapists.

HB 68 defines a “gender-related condition” broadly to include any situation where an individual feels an incongruence between their gender identity and biological sex, with gender dysphoria being the most commonly recognized condition. Before addressing any gender-related condition, mental health professionals are required by law to first screen the minor for other comorbidities, including depression, anxiety, ADHD, and autism spectrum disorder. Additionally, professionals must assess the minor for signs of physical, sexual, mental, or emotional abuse, as well as other traumas that might be influencing the gender-related condition.

In other words, providers must account for the order of operations required by HB 68 (diagnosing gender conditions last) and parents/guardians need to fully consent to that plan of action. If providers do not take both steps, then they are considered to be engaging in “unprofessional conduct” that could subject them to discipline by their professional licensing board.

If you have any questions regarding HB 68 or would like assistance ensuring your policies and procedures comply with the new law or any of its provisions, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.


The Rising Threat from Insiders – Get Your House in Order

As its name implies, an ‘Insider Threat’ originates inside an organization. An ‘insider’ is any person who has or had authorized access to or knowledge of an organization’s resources, including personnel, facilities, information, equipment, networks, and systems. ‘Insider threat’ can manifest from malicious, complacent, negligent or unintentional acts that negatively affect the integrity, confidentiality, and availability of the organization, its data, personnel, or facilities. Certainly, ‘Insider Threat’ can be an activity by a bad actor employee, but can also arise from an inadvertent or unknowing action inside an organization (such as an employee who unintentionally opens a phishing email or clicks on a malicious link).

In Cybersecurity– A Good Offense is the Best Defense

2021 has been a watershed moment for cybersecurity incidents as cybercrime has become a frequent headline and cyber criminals have thrived on unsuspecting and/or unprepared businesses and institutions. For example, the Solar Winds attack exposed sensitive data from top companies like Microsoft as well government agencies[1] and the Colonial Pipeline attack substantially disrupted the petroleum supply chain[2]. We have seen an almost 20% increase in data breaches and attacks since last year.

Changes to Medicare’s Physician Fee Schedule and Outpatient Prospective Payment System

Come the beginning of 2022, both the Medicare Physician Fee Schedule (“MPFS”) and Outpatient Prospective Payment System (“OPPS”) will look a little different. As a refresher, the MPFS lists the fees associated with reimbursement of services to providers at certain facilities, taking into account geography and costs. By contrast, OPPS sets reimbursement rates for hospitals and community mental health centers for outpatient services, which are determined in advance. A summary of some of the more pertinent changes to each rule will be outlined below.

CMS to Once Again Reprocess Outpatient Clinic Claims

The Hospital Outpatient Prospective Payment System (OPPS) Rule was passed in November 2018, which was intended to prevent the Centers for Medicare and Medicaid Services (CMS) from paying more for services rendered in outpatient settings than what they paid for the same services rendered in physician offices that are simply owned by hospitals or health systems.[1]

New Vaccine Requirement for Select CMS-Participating Facilities

On November 4, 2021, the Centers for Medicare and Medicaid (“CMS”) released a new rule requiring certain healthcare facilities to implement policies requiring employees to be vaccinated against COVID-19. It does not matter if a staff member does not perform patient treatment services, they must still be vaccinated if an employee of an applicable facility.