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Effective April 30, 2025, The State Medical Board of Ohio has amended Rule 4731-31-01, marking a significant shift in how physicians and physician assistants are expected to evaluate and clear youth athletes following a concussion.

What Changed?

The 2022 Amsterdam Consensus Statement on Concussion in Sport, developed over five years by an international panel of experts, offers a deeper and nuanced understanding of sport-related concussions. It introduces new clinical tools, redefines concussion diagnosis, and promotes flexible, symptom-guided return-to-play protocols. Key developments include:

• New assessment tools like SCOAT6 and Child SCOAT6, designed for use during the subacute recovery phase.
• Refined diagnostic criteria, discouraging over-reliance on imaging or static symptom checklists.
• Updated return-to-play guidance, encouraging early physical and cognitive re-engagement when safe.
• Expanded support for pediatric and para-athletes with tailored accommodations.
• Increased emphasis on mental health, recognizing how anxiety, depression, and stress may impact recovery.

“The Amsterdam Consensus redefines best practices. It doesn’t just update the tools—it reframes the conversation around individualized recovery and ethical care.”
— Levi Tkach, Esq., Graff & McGovern, LPA

What the New Rule Requires

Under the revised Rule 4731-31-01, Ohio physicians must now align their concussion evaluations and return-to-play decisions with the Amsterdam Statement. Specifically, they are required to:

• Use the State Medical Board’s official model clearance form (available online) when issuing written clearance.
• Incorporate updated tools such as SCAT6, SCOAT6, and their pediatric equivalents into their assessment protocols.
• Stay current with advancements in concussion science and care standards.

What This Means for Ohio Healthcare Providers

Physicians and physician assistants working in sports medicine, pediatrics, or school-based healthcare should take immediate steps to ensure compliance:

• Review the Amsterdam Consensus and update internal protocols accordingly.
• Confirm that any involved physician assistants meet the training and supervision requirements.
• Use the official clearance form to avoid administrative issues or liability concerns.
• Consider incorporating serial evaluations (such as the SCOAT6) in cases involving persistent or complex symptoms.

Ignoring these updates could result in regulatory action or exposure to civil liability—especially in cases where an athlete returns to play too soon or suffers additional harm.

Key Takeaways from Ohio’s Updated Rule

Per Final Rule 4731-31-01, physicians in Ohio are now required to:

• Base concussion assessments and return-to-play decisions on the 2022 Amsterdam Consensus Statement.
• Use the State Medical Board’s official model clearance form for documenting written clearance.
• Remain up to date on concussion science and evaluation tools, including SCAT6, SCOAT6, and their pediatric versions.

Providers involved in sports medicine, pediatrics, and school athletics should review and integrate the Amsterdam Statement and tools into internal protocols.  Providers should ensure consistent use of the required model clearance form to avoid regulatory scrutiny or potential liability.  Consider the use of serial assessments like SCOAT6 in managing cases with persistent or complex symptom profiles.

Physician assistants may clear youth athletes only if they:

1. Are authorized by a supervising physician whose practice includes concussion management;
2. Have completed training consistent with the Amsterdam guidance; and
3. Use the designated return-to-play clearance form.

These requirements apply to assessments under Ohio Revised Code Sections 3313.539 and 3707.511, which govern youth sports concussion management.

Failure to adopt these updated standards could result in regulatory action or civil exposure, particularly in cases involving premature return or exacerbated injuries.

Supporting the Providers Who Support Athletes

At Graff & McGovern, LPA, we assist physicians, physician assistants, and athletic program directors in understanding and implementing regulatory changes. Whether you’re building new protocols or facing board scrutiny, our legal team can help you navigate compliance.

📩 Questions about integrating Amsterdam protocols into your practice?

Need help interpreting the new concussion clearance rule or implementing the Amsterdam protocols in your practice? Contact us today.