Navigating the Unique Challenges of Healthcare Insolvencies

Recording of a 90-minute CLE video webinar with Q&A

Conducted on Tuesday, December 1, 2020

Recorded event now available

or call 1-800-926-7926
Course Materials

This CLE course will provide healthcare counsel with guidance on the unique legal issues for hospitals and other healthcare providers facing insolvency. The panel will explain the factors that make healthcare provider bankruptcies incredibly complicated, discuss the implications and potential ramifications for providers in bankruptcy proceedings, and outline strategic approaches for restructuring.


COVID-19 created a financial hardship for many healthcare providers across the nation. According to the American Hospital Association, estimated losses were $200 billion between Mar. 1, 2020, and June 30, 2020. Much of these losses were due to canceled services.

Other contributing factors that were putting pressure on providers even before the pandemic include cuts to Medicare and Medicaid payments, increased charitable care, low levels of reimbursements by insurers and third-party administrators, and mismanagement. For healthcare debtors, lenders, creditors, and investors, there can be significant legal issues and factors that make healthcare restructuring incredibly complicated:

  • How has CARES Act funding and the temporary expansion of the Small Business Restructuring Act affected the healthcare bankruptcy landscape?
  • How will the courts balance creditors' rights and interests against the desire to keep a hospital open and operating--particularly if the hospital is the only one available to an underserved population?
  • If municipal bonds funded a healthcare facility, which is ultimately liable to the creditors? Can a county or hospital authority seek to shed liabilities through the hospital's bankruptcy, without filing bankruptcy of their own?
  • Will Medicare provider agreements be treated as executory contracts that can be assumed and assigned to a buyer (subject to the cure of any existing defaults)? Can Medicare obligations be extinguished in a Section 363 sale?
  • What is the impact of the Bankruptcy Code's automatic stay on efforts by insurers and TPAs to recoup alleged overpayments? May the debtor sue the insurers and TPAs in the friendly forum of the bankruptcy court? How might this be affected by ERISA preemption?
  • How can a buyer return a bankruptcy healthcare provider to profitability, given all of the challenges these entities face?

Counsel and financial advisors to distressed healthcare providers, their lenders, creditors, and investors must carefully consider the implications of the unique issues when navigating bankruptcy and framing a restructuring strategy.

Listen as our authoritative panel of practitioners examines the unique aspects that arise when insolvency involves a healthcare facility, including the impact of the automatic stay on Medicare provider agreements, special issues arising in Section 363 sales and potential pitfalls and opportunities. The panel will guide counsel to providers and provider creditors for strategically navigating insolvency and the bankruptcy process.



  1. Overview of the state of healthcare bankruptcy filings
  2. Impact of covid-19 and the CARES Act
  3. Unique aspects of healthcare insolvencies Numerous stakeholders and competing interests beyond the debtor-creditor dynamic
    1. Impact of the automatic stay on Medicare provider agreements and recoupments
    2. Patient care ombudsman / cost of maintaining patient care
    3. Maintaining/monetizing certificates of need
    4. Challenges in Section 363 sales, including regulatory compliance issues
    5. Privacy issues and HIPAA requirements; retention of medical records
    6. Pre-petition malpractice claims
    7. Operational restructuring
  4. Guidance on navigating the bankruptcy process for healthcare providers and their creditors


The panel will review these and other key issues:

  • What are the special issues facing hospitals and other healthcare providers when it is time to restructure or file for bankruptcy?
  • What impact will these unique issues have on insolvency?
  • What steps can counsel take to increase the chances of a successful reorganization through the bankruptcy process?


Fleming, Steven
Steven J. Fleming

Principal | Business Recovery Services

Mr. Fleming assists clients in the areas of strategic planning, complex debt restructurings, business enterprise...  |  Read More

Kovsky-Apap, Deborah
Deborah Kovsky-Apap

Troutman Pepper

Ms. Kovsky-Apap focuses her practice on bankruptcy and out-of-court workouts. She also has substantial litigation...  |  Read More

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Strafford will process CLE credit for one person on each recording. All formats include course handouts.

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