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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.


Ohio’s Managed Care Overhaul Delayed – New Implementation Timeline

At the direction of Governor Mike DeWine, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process in 2019. ODM’s stated vision for the procurement was to focus on people and not just the business of managed care. This is the first structural change to Ohio’s managed care system since the Centers for Medicare & Medicaid Services' (CMS) approval of Ohio’s Medicaid program in 2005. Initially, all of the new managed care programs were supposed to be implemented starting on July 1, 2022. However, ODM Director Maureen Corcoran recently confirmed that this date will be pushed back for several managed care-related programs.

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.

Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.

No Surprises Act Update: The IDR Portal is Open

The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.

Updated FAQs for the No Surprises Act - Good Faith Estimates

The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.