Business

Most health care businesses rely on Medicare, Medicaid and insurance company monies. As a result, understanding the reimbursement system is key to a business’s success or failure. Business leaders on the provider and managed-care side will discuss the rates and pressures on health care businesses, including in insurance company mergers/renegotiations of contracts, and the impact of hospital readmissions, fraud and ACOs. Other panelists will provide a detailed overview of the legal framework, structure and pitfalls of the reimbursement system, including regulatory dos and don’ts and how to keep the money flowing during a restructuring (whether in or outside of bankruptcy).

How do investors and lenders view the health care services industry? Investors will outline criteria for investing in deals, identify key trends and issues, and provide various return characteristics regarding their investments by type of investment. The lenders will outline their views of risk within the various sectors, outline their views of the current state of the market, provide general terms regarding their specific products, and provide a general overview of how their loans are performing. There also will be a focus on some of the more challenging sectors of the industry, particularly hospitals, senior housing and post-acute care. Finally, this panel will highlight the legal challenges in structuring a health care loan, how to attempt to isolate liabilities, and how to recover your money when you need to take legal action on account of defaults, including navigating complex regulations when dealing with patients, records and medical waste, as well as the complexities of a restructuring.

This panel of experts leave conference attendees with key takeaways that will help them know where to find their next opportunities. These experts highlight the financial and legal issues facing the distressed sectors of the industry that you need to know as you work through the restructuring issues facing these sectors.

With Amazon, Walmart and others entering the health care market and partnering with established players, there will be winners and losers as health care businesses navigate the changing delivery of care — from the minute clinics to telemedicine to concierge medicine to whatever might be coming next. This panel will provide an overview of the changes in the delivery of health care, including the legal implications of those changes such as privacy concerns, security breaches, antitrust implications and other legal challenges as the law tries to catch up with innovation.

CEOs share their insights on the challenges facing the industry, the new innovations that will transform the industry, and how health care policy is expected to change, when it will change, what needs to change, and how politics plays into all of this!

This panel will explore the effectiveness (and, sometimes, lack thereof) of creditor strategies to restrict by contract a borrower’s ability to obtain bankruptcy relief, whether by limiting the ability of a corporate borrower to seek bankruptcy relief without certain stakeholder approvals, limiting the type of available bankruptcy relief, choosing which country’s bankruptcy laws will apply to an insolvency proceeding involving the borrower, bankruptcy-remote structuring techniques, and other means. For example, the U.S. Court of Appeals for the Fifth Circuit recently upheld a “golden share” arrangement whereby a creditor was able to prohibit the debtor limited liability company from filing bankruptcy; and in the international realm, choice of law clauses have at times limited a debtor’s ability to obtain relief under the Model Law for Cross-Border Insolvency. This panel will also explore variations in international public policies with respect to restrictions on a borrower’s ability to seek bankruptcy relief.

This panel will examine the effects thus far of the Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA), as well as Puerto Rico’s economy, including where it came from, where it is now and where it is going.

This panel will explore the roles, responsibilities, benefits, and liabilities in using independent directors through multi-jurisdictional insolvency proceedings and will discuss using directors strategically throughout the life of a company. The panelists will explain the three typical stages of a company where directors could be instructed — going concern, insolvency, and emergence from a restructuring — then explain the roles and responsibilities at each of these appointments. The session would also overlay the jurisdictional distinctions among various administrative proceedings, including offshore liquidations, U.S. bankruptcy, U.S. receiverships, and common law receiverships. The panelists will offer real-world examples to show the differences and how the role of the director is utilized, as well as what is at stake for them, the company, the creditors and the investors.

What are critical-access hospitals, and why are they important? This panel will discuss alternative solutions to producing additional cash flow for failing hospitals, which need to be closely scrutinized by health care professionals familiar with licensing, reimbursement, anti-kickbacks and patient-brokering limitations. The panel will also cover violations of the False Claims Act, Stark Law and Anti-Kickback Statute, as well as state law cases on patient-brokering and the questioning of medical necessity, clinical laboratory outreach programs, physician employment arrangements involving telemedicine, prescription programs and compounding, criminal statutes and DOJ/state regulator issues, how to reorganize legally, dealing with CMS (Medicare/Medicaid), nongovernmental and third-party commercial payers during a restructuring, and general rules on pass-through billing for outreach programs.

Recent developments in offshore law have increased the effectiveness of the tools available to trace and recover assets through the offshore insolvency process. This panel will be conducted in a formal debate style, using the format of first proposition followed by first opposition, then second proposition followed by second opposition. The debates will look at the illegality defense, clawback claims, the dishonesty test and foreign officeholder recognition, among other issues. Each debate will be seven minutes with a four-minute closing, followed by a vote.