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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.  


New $100,000 Fee on H-1B Petitions – Legal Immigration

President Trump issued an Executive Order (EO) imposing a $100,000 payment to accompany any new H-1B visa petitions submitted after 12:01 a.m. eastern time on September 21, 2025 and will remain in place for 12 months (unless extended).

Implications of Supreme Court Stay for Business Operations in Noem v. Vasquez Perdomo

On September 8, 2025, the U.S. Supreme Court temporarily reinstated immigration officers’ authority to conduct brief stops based on factors such as location, work type, language, or appearance. This stay in Noem v. Vasquez Perdomo allows enforcement actions to resume in California pending appeal. Employers in industries like construction, agriculture, landscaping, and day labor should prepare for increased worksite disruptions and review compliance protocols.

Ohio House Bill 429: Potential Relief for Providers Facing Same-Day Reimbursement Restrictions

Ohio House Bill 429 aims to prevent third-party payers from reducing provider reimbursement for multiple procedures performed on the same day. The bill could improve payment practices for a range of specialties, including surgery and gastroenterology.

FTC Continues to Target Noncompetes

The FTC is intensifying its focus on noncompete agreements in healthcare, urging employers to review contracts for compliance. While Ohio still generally enforces noncompetes, pending legislation could limit their use.

Medicare Updates: Prior Authorizations and Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) has announced two key updates effective January 1, 2026: a six-state prior authorization pilot program targeting high-risk services under the WISeR Model, and proposed revisions to the Physician Fee Schedule (PFS) that include increased payment rates, expanded telehealth coverage, and updated policies for chronic care, behavioral health, and rural providers.