Advising Health Care Providers in the Wake of COVID-19

Health care attorney Adam Balick of Balick & Balick never thought he’d be in the triage business. That’s more in line with the work of his health-care provider clientele. But the COVID-19 outbreak has forced him to approach his practice in an entirely new way. “I’m not sure how else to say it besides it’s been sheer chaos,” Balick says. “The federal government is changing laws in real time, and all of these health-care providers—How do they know the law has changed? How do they, in turn, instruct their people, and how do they interpret how it relates to them?”

Balick has become the interpreter. “The government is doing the best it can by putting notices up on public websites, but it’s not targeted,” Balick says. “So one of the things firms representing health-care providers right now are dealing with is, ‘How do we send out these mass emails, sometimes a few a day, in a way that does not inundate an already very anxious and stressed out population?”

An example of a real-time policy change is the state and federal requirements for telemedicine. The government is trying to make it easier for health care providers to treat patients remotely. Under federal law, health care providers can’t provide telemedicine services without encrypted technology. “This kind of technology is  required under HIPPA” Balick says. But [on March 17], the Office of Civil Rights announced they were no longer going to enforce that requirement, to allow doctors without HIPPA-compliant technology to connect with their patients. So now, basically any doctor with an internet connection who wants to practice telemedicine can do so. The State of Delaware also relaxed its telemedicine regulations, temporarily removing the requirement of an initial visual encounter before allowing doctors to treat patients remotely. “We’ve been reaching out to our clients to let them know about these kinds of changes and to answer questions that they have,” Balick says.

The mechanism for doing so, however, has been tricky. “Unfortunately, I don’t think this is the last time something like this might happen,” Balick says. “Once we get through this and have our feet under us, we’d like to look into how best to streamline client communication. With so many subsets of different clients—hospitals get this messaging, physicians’ practices get this, nursing homes get this—even that’s not enough, because some of our physician practices are hospital-owned, for example. We want to be able to tee up extremely targeted communication.”

Since the outbreak, Balick has also worked with clients to creatively solve critical problems. “We represent a network of nursing facilities that need to provide 24/7 care, and a lot of them rely on both nurses and aides, a lot of whom are losing their child care,” he says.

The facilities can’t remain operational unless they meet the state’s minimum staffing thresholds. To remain open, one of his clients asked Balick to help him set up an on-site day care program. “Of course, day cares in Delaware are regulated, and you have to comply with the law, but we don’t have the time to go through a licensing process,” Balick says. “So what we’re trying to do is fit them into some of the existing licensing exemptions.”

Then there’s the psychological impact. One of Balick’s clients, a physician who works in an older doctor’s practice, has found himself in the midst of an economic freefall trying to set up a new business and become operational, “like, today,” Balick says. The doctor for whom his client worked decided he was done. “This was an older doctor looking at what’s going on in the world and deciding, ‘I’ve had enough. I want to spend the time I have left with family and enjoying life,’” Balick says. “So the questions we’re trying to figure out is, ‘How does my client keep his patients? What happens to patients with procedures scheduled? How do we get a new business set up immediately?’”

Balick is feeling the emotional impact, too.

“Every day I hear something that I never imagined possible,” he says. “What keeps me up at night is wondering what’s going to happen to my business. I’ve got a client who is calling me to say that they can’t pay rent, so what are the chances that they’re going to pay my bills? I’m very worried, and I keep looking around at my staff. I want to keep my people employed and not disrupt their lives, but I don’t know how long this plays out.”

For more information and articles for legal professionals navigating COVID-19 as it relates to their law practice and clients, visit FindLaw’s COVID-19 resource center or visit superlawyers.com/articles (search for COVID-19).