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Top Compliance Risks for Ohio Med-Spas in 2025

Client Alert

Do you own a med-spa with a Terminal Distributor of Dangerous Drugs (“TDDD”) license? If so, it is important that you and your practice comply with applicable Board of Pharmacy rules and regulations.  

The Ohio Board of Pharmacy (“BOP”) conducts regular inspections and is finding that many med-spas are not complying with Ohio laws. In 2025 alone, the overwhelming majority of TDDD summary suspensions involved med-spas. As a result of non-compliance, inspected practices are subjected to BOP enforcement actions. A review of recent BOP enforcement actions shows that the following are some of the top inspection violations committed by Ohio med-spas:  

  • Purchasing and administering drugs that are not approved by the Food and Drug Administration (“FDA”), including those labeled “for research purposes only”;
  • Purchasing and administering drugs from unlicensed sellers and drug distributors;
  • Improper drug storage, such as storing drugs in areas open to the public, in unlocked offices or cabinets, at the incorrect temperature, and keeping expired drugs in active stock;
  • Insufficient drug records and drug labeling, such as not keeping drug destruction records, temperature logs, drug administration records, and storing compounded drugs without a beyond use date (“BUD”);     
  • Lack of necessary prescriber oversight, such as the Responsible Person not being physically present for a sufficient amount of time, and prescribers not conducting applicable final checks of compounded drugs;     
  • Storing and utilizing pre-drawn syringes that do not adhere to immediate use, non-hazardous sterile compounding rules;  
  • Operating in unsanitary conditions, such as using single-dose vials on more than one patient; and
  • Operating as pick-up stations in violation of OAC Rule 4729:5-5-14.

The BOP applies various penalties for these violations, including summary suspensions of TDDD licenses, permanent revocations of TDDD licenses, monetary penalties, probation periods, continued pharmacy education requirements, and written reprimands from the BOP.     

To learn more about Ohio med-spa compliance and how Ohio Board of Pharmacy inspections can impact your practice, please contact BMD Member Jeana Singleton at jmsingleton@bmdllc.com or 330-253-2001.  


Pre and Postnuptial Agreements | Necessary, Maybe, What Happened to Forever?

Both Florida and Ohio now allow clients to enter into a prenuptial or postnuptial agreement prior to marriage or after marriage (Ohio previously did not allow postnuptial agreements). Both documents have statutory guidelines that must be followed in terms of execution and financial disclosure.

DHS Ends All Employment Authorization Auto-Extensions

Effective October 30, 2025, DHS ends all automatic work authorization renewals. The 540-day extension applies only to renewals filed before this date, and there is no grace period for expired EADs filed on or after October 30. Employers must audit EADs, train staff, ensure I-9 compliance, and plan for work authorization gaps. Penalties for noncompliance can be severe.

CMS’s Rural Health Funding Announcement

CMS has announced a $50 billion Rural Health Transformation (RHT) Program to improve healthcare access, quality, and outcomes in rural communities. All states are eligible to apply for funding by November 5, 2025. Half of the funds will be distributed equally, with the remainder based on state-specific factors. The program supports evidence-based initiatives, workforce recruitment, and access to treatment services, with awards assessed annually

Expanding Access to Care: Ohio’s Effort to Modernize APRN Practice Through Ohio SB 258 and HB 508

Ohio is moving to expand access to healthcare through Senate Bill 258 and House Bill 508, which would modernize APRN practice by removing the outdated requirement for a physician contract. This change would allow nurse practitioners, nurse midwives, and clinical nurse specialists to provide care more efficiently, especially in underserved areas, while maintaining high-quality, cost-effective care.

Cleveland Joins the Pay Transparency Movement: What Employers Need to Know

Beginning October 27, 2025, all Cleveland employers with 15 or more employees will be prohibited from asking applicants about their pay history and will be required to include reasonable pay ranges in all job postings where the position will be performed, solicited, considered, or processed in Cleveland. The ordinance is intended to help close the gender wage gap and promote greater pay equity across the city.