Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

Legal Uncertainties Remain Following Passage of Issue 1 in Ohio

Client Alert

In the November 2023 General Election, Ohio voters passed Issue 1 which, among other things, “[e]stablish[es] in the Constitution of the State of Ohio  an individual right to one’s own reproductive medical treatment, including but not limited  to abortion”. Despite passage of Issue 1, questions persist about how its codification on December 7 affects previously passed legislation restricting abortion and related pending court cases.

On the day the ballot measure became effective, Ohio Attorney General Dave Yost said that Ohio’s new constitutional right to reproductive decisions overrides the state’s ban on most abortions (the previously passed “Heartbeat Law"), but that the state’s appeal of a lower court’s decision to pause enforcement of the Heartbeat Law should go forward.

On September 2, 2022, in Preterm-Cleveland v. Yost, five groups, including the American Civil Liberty Union (ACLU) of Ohio, filed a lawsuit in Hamilton County Common Pleas Court seeking to block enforcement of the Heartbeat Law. The Hamilton County Common Pleas Court held that abortion is a “fundamental right” and that the Heartbeat Law violates that right. The court issued a preliminary injunction in October 2022, preventing enforcement of the Heartbeat Law.

In response, Ohio Attorney General Yost appealed the preliminary injunction to the First District Court of Appeals, which ultimately dismissed the case. Yost appealed to the Ohio Supreme Court, asking the court to rule on two important issues:

  1. Can preliminary injunctions that restrict state law be appealed by the state?
  2. Because Ohio courts lack jurisdiction to issue injunctive relief to parties who lack standing, can third parties (e.g., abortion clinics) challenge state laws (in this case, the Heartbeat Law)?

Following passage of Issue 1, the Ohio Supreme Court asked both sides to file new briefs that address the impact of Issue 1 on the case pending before it. In Attorney General Yost’s brief, he argued that the law itself is not at issue, but rather the two procedural issues described above. In his brief, Yost indicated that, substantively, Issue 1 overrides the Heartbeat Law.

In its brief submitted on behalf of the Appellees, the ACLU of Ohio argues that Issue 1 renders the Heartbeat Law unenforceable and that Yost’s prior appeal of the 2022 preliminary injunction of that law is moot, rendering the case unable to proceed. According to the brief, because the State cannot be harmed by being prevented from enforcing a law that Attorney General Yost admits violates the Ohio Constitution, there is no harm for the State to allege.

While the Supreme Court of Ohio considers both briefs, many providers of reproductive health care in Ohio are waiting on concrete legal guidance before they stop following Ohio's current abortion restrictions, including requiring patients to wait 24 hours after an initial appointment to have an abortion. The Supreme Court of Ohio’s ruling on the procedural issues stemming from Issue 1 should clarify the new legal boundaries for providers.

If you have questions about the content of this Client Alert, or the passage of Issue 1, please feel free to reach out to BMD Member Daphne Kackloudis at dlkackloudis@bmdllc.com or BMD Partner Ashley Watson at abwatson@bmdllc.com.


“I’m Out Of Here!” Now What?

We all know that the healthcare industry is experiencing a wave of integration. This trend has been evident for many years. Fewer physicians are willing to assume the legal, financial and other business risks associated with owning their own practices. More and more physicians, including anesthesiologists, are becoming employed by large physician groups, health systems and national providers. This shift necessarily involves not only entry into new employment arrangements but also the termination of existing relationships. And those terminations are often governed by written employment agreements, state and federal healthcare laws and employer benefit plans and other policies and procedures. Before pursuing their next opportunity, physicians should pause for a moment and first attend to the arrangement that they are leaving. Departing physicians need to understand their legal rights and obligations when leaving their current employment relationships in order to avoid unintended consequences and detrimental missteps along the way. Here are a few words of practical advice for physicians contemplating an exit from their current employment arrangements.

Investment Training for the Second and Third Generations

Consider this scenario. Mom and Dad started the business from the ground up. Over the decades it has expanded into a money-making machine. They are able to sell the business and it results in a multimillion-dollar payday for their labors. The excess money has allowed Mom and Dad to invest with various financial advising firms, several fund management groups, and directly with new startups and joint ventures. Their experience has made them savvy investors, with a detailed understanding of how much to invest, when, and where. They cannot justify formation of a full family office with dedicated investors to manage the funds, but Mom and Dad have set up a trust fund for the children to allow these investments to continue to grow over the years. Eventually, Mom and Dad pass. Their children enjoy the fruits of their labors, and, by the time the grandchildren are adults, Mom and Dad's savvy investments are gone.

Provider Relief Funds – Continued Confusion Regarding Reporting Requirements and Lost Revenues

In Fall 2020, HHS issued multiple rounds of guidance and FAQs regarding the reporting requirements for the Provider Relief Funds, the most recently published notice being November 2, 2020 and December 11, 2020. Specifically, the reporting portal for the use of the funds in 2020 was scheduled to open on January 15, 2021. Although there was much speculation as to whether this would occur. And, as of the date of this article, the portal was not opened.

Ohio S.B. 310 Loosens Practice Barrier for Advanced Practice Providers

S.B. 310, signed by Ohio Governor DeWine and effective from December 29, 2020 until May 1, 2021, provides flexibility regarding the regulatorily mandated supervision and collaboration agreements for physician assistants, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners working in a hospital or other health care facility. Originally drafted as a bill to distribute federal COVID funding to local subdivisions, the healthcare related provisions were added to help relieve some of the stresses hospitals and other healthcare facilities are facing during the COVID-19 pandemic.

HHS Issues Opinion Regarding Illegal Attempts by Drug Manufacturers to Deny 340B Discounts under Contract Pharmacy Arrangements

The federal 340B discount drug program is a safety net for many federally qualified health centers, disproportionate share hospitals, and other covered entities. This program allows these providers to obtain discount pricing on drugs which in turn allows the providers to better serve their patient populations and provide their patients with access to vital health care services. Over the years, the 340B program has undergone intense scrutiny, particularly by drug manufacturers who are required by federal law to provide the discounted pricing.