governmental provider payments must
factor in the likely carryover liability.
Fortunately, CMS is often willing to term
out such liability over a multiyear period.
Frequently, one or more collective
bargaining agreements also must be
addressed in a SNICH restructuring.
More important than wage concessions,
work rule flexibility has the biggest
impact on improving operations.
The ACA will only make this issue
more important as institutions—and
indirectly, through long-term wage
growth, their employees—are rewarded
or penalized based on how well they do
in providing quality and value-driven
care as healthcare providers move
away from a pay-for-service model.
The ACA may have its supporters
and its critics, but one thing is clear:
the new law will certainly have an
effect on the U.S. healthcare system
going forward. Unfortunately, the
unintended consequences of the ACA
that have occurred thus far and will
likely continue to occur in the future do
not auger well for SNICHs, especially
those that fail to take proactive steps
Thomas Buck, CTP, is a partner in the Bankruptcy
and Restructuring Group of EisnerAmper LLP.
He is a crisis management professional with
nearly 15 years of experience advising distressed
businesses in a variety of industries, including
healthcare. Among the healthcare matters he has
been involved with are North Oakland Medical
Centers, St. Mary’s Hospital, KidsPeace Corporation,
and 710 Long Ridge Road Operating Company.
In addition to being a CTP, Buck is CIRA, and he
holds an MBA from Wake Forest University.
Paul J. Ricotta is a partner at Mintz, Levin,
Cohn, Ferris, Glovsky and Popeo P.C. in the
firm's Boston and New York offices. He has more
than 35 years of experience in commercial
workouts, bankruptcies, and other insolvency
proceedings, and has represented various parties
in a wide variety of healthcare insolvency matters.
Ricotta is a fellow of the American College of
Bankruptcy, and has been listed in Best Lawyers
in America and in Chambers USA: America's
Leading Lawyers for Business since 2001.
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