Resources

COVID-19 Checklist for Healthcare Providers

April 22, 2020

The checklist below is intended to assist healthcare providers in thinking through various issues that might need to be considered or addressed in light of the COVID-19 pandemic.

Healthcare regulatory and risk management

  • New telehealth opportunities arising from liberalization of rules
  • Waivers of licensing requirements to practice across state lines
  • Relaxed supervision requirements and increased autonomy for non-physician practitioners
  • HIPAA: Disclosures to first responders and public health authorities
  • Informed consents for elective procedures
  • Visitor policies and related releases of liability
  • Emergency credentialing procedures
  • Crisis standards of care and related immunity issues for healthcare professionals
  • Annexing beds from another facility pursuant state health department guidelines
  • Physician-owned hospital temporary expansion ability
  • EMTALA obligations:  What has changed and what has not
  • CMS blanket Stark Law waivers related to COVID-19 purposes and OIG enforcement discretion for federal anti-kickback statute
  • CMS recommendations for reopening facilities

Labor and employment

  • Confidentiality of medical information related to COVID-19
  • Paid sick leave and expanded FMLA leave under Families First Coronavirus Response Act (FFCRA)
  • Exemptions to paid sick leave and expanded FMLA leave for healthcare providers and emergency responders
  • Accommodation, interactive process, and return to work
  • Compliance with anti-discrimination laws
  • Furloughs and layoffs
    • Health insurance coverage
    • Availability of unemployment benefits
    • WARN Act compliance
    • Wage and hour issues
  • Workplace safety and CDC guidelines

Contracting, real estate, and M&A transactions

  • Physician contracting
    • Redeployment and changes to contractual duties
    • Changes to physician compensation
  • Non-performance of contracts: force majeure, impossibility, and frustration of purpose
  • Material adverse effect/material adverse change provisions
  • Supply chain management, price gouging, and reporting to consumer protection agencies
  • Commercial insurance advancement of shared savings incentives and other payments
  • Closing conditions and termination rights
  • Extension of confidentiality or standstill provisions for deals on pause
  • Purchase price adjustments during financial downturn
  • Business interruption insurance
  • Loan restructurings and deferment programs
  • Renegotiation of mortgage rates and terms, waiver of defaults, relaxed financial covenants
  • Lease amendments to defer or suspend rent or waive defaults
  • Electronic signatures and remote online notarization

Corporate governance

  • Changes to open meeting laws to permit meetings by video conference or teleconference
  • Amendments to bylaws of nonprofit corporations to permit virtual meetings
  • Amendments to bylaws of nonprofit corporations to permit actions by less than unanimous written consent
  • Amendment to organizational documents of nonprofit corporations to permit the  Board of Directors to govern and manage in a manner different from the usual laws and provisions applicable to corporations
  • Amendment to bylaws of nonprofit corporations to permit the Board Chair, rather than the full Board, to appoint committees
  • Amendments to organizational documents of other entities to permit virtual meetings or actions by written consent

Government assistance programs

  • CARES Act Medicare provider relief fund
    • Required certifications
    • Third party claims to funds
  • CMS Accelerated and Advance Payment Program
  • SBA Paycheck Protection Program and Economic Injury Disaster Loan Programs
    • Determine the right program for your organization
    • Eligibility tests
  • Federal Reserve Main Street Lending Program
  • FCC COVID-19 Telehealth Program
  • Oklahoma City and Tulsa small business relief programs and other municipal relief programs

Creditors’ rights and financial issues

  • Renegotiation of payment terms with vendors and suppliers
  • Accounts receivable and accounts payable deferrals and restructuring of payment terms
  • In cases involving financial distress, evaluation of alternatives and options for reorganization and bankruptcy protection
  • Hospital and clinic closings

Legal proceedings

  • Liability risks relating to COVID-19, particularly infection control, lack of capacity to provide care or treatment, insufficient or inadequate protective equipment and supplies for healthcare workers and patients, overcrowding in facilities inhibiting social distancing, refusal to treat patients due to lack of testing kits, staff, or resources, notifications to insurers
  • Immunity protections for health care providers and facilities
  • Refusals by insurers to provide coverage

Intellectual property

  • Remote work and data privacy/cybersecurity issues
  • CARES Act extension of certain patent-related and trademark-related deadlines
  • Research funding
  • Publications and copyrights

Tax

  • Federal and state filing and payment extensions
  • Paid sick leave and expanded FMLA leave tax credits

For a PDF version of this checklist, click here.

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