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A Guide to Shepherding Healthcare Providers Through Bankruptcy Proceedings

(877 reviews)

Produced on April 10, 2018

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Course Information

Time 1h 4m
Difficulty Intermediate
Topics covered in this course: Health Care

Course Description

The 21st century has handed healthcare providers significant financial and economic challenges. Payers, public and private, are balking at paying the ever increasing cost of modern health care and pushing providers to transition from fee-for-service to value-based revenue models. Medical care is increasingly relocating from hospitals to other venues (e.g., ambulatory surgery centers, urgent care centers, community-based programs), negatively impacting hospital revenues, and for-profit entities are moving into the healthcare industry - long the domain of non-profit entities.

The drive under HIPAA and the HITECH Act to digitize health records has increased the cost and complexity of providing healthcare, and cash-strapped state and local governmental entities are challenging the property tax exemptions long enjoyed by non-profit healthcare providers. At the Federal level, the Affordable Care Act now requires non-profit healthcare providers to demonstrate the benefits they provide to the community as a condition to retaining their Federal tax exemptions, and the precarious state of the Affordable Care Act has added uncertainty to challenges to healthcare providers and health insurers. Consequently, healthcare bankruptcies spiked during the first half of 2017, and the challenges continue.

Special rules impact healthcare bankruptcies. These rules address (i) the eligibility for bankruptcy relief and a discharge of debts; (ii) jurisdiction over Medicare and Medicaid disputes; (iii) the treatment of Medicare and Medicaid provider agreements - the lifeblood of most healthcare providers; (iv) asset sales and divestitures, particularly when a non-profit provider is being converted to a for-profit provider; (v) the role of the Patient Care Ombudsman; (vi) the disposition of patient records; (vii) hospital closings; and (viii) the impact of federal (e.g., antitrust) and state laws (e.g., Certificate of Need laws) that regulate healthcare providers outside of the bankruptcy context.

This program, taught by David Crapo, Of Counsel to Gibbons P.C. with extensive experience in bankruptcy matters and a focus on the representation of healthcare providers, will address the impact of those special rules on healthcare provider’s bankruptcy proceedings, and suggest best practices to consider to achieve the best result in bankruptcy for a financially troubled provider.

Learning Objectives:
  1. Review the laws and regulations that impact a healthcare provider’s bankruptcy
  2. Discuss how those laws apply in specific bankruptcy contexts
  3. Identify best practices to follow in shepherding a healthcare provider through bankruptcy

Credit Information

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David N. Crapo

Gibbons Law

David N. Crapo has extensive experience in the fields of bankruptcy, debtor/creditor law, commercial law and healthcare. His experience includes the negotiation and preparation of loan agreements and pleadings in connection with debtor-in-possession financing and/or use of the cash collateral of financial institutions, and other lenders, as well as analysis of commercial, corporate and municipal bond transactions to assess bankruptcy and insolvency-related risks and to make recommendations for minimizing those risks.

Mr. Crapo has represented numerous clients in connection with HIPAA and healthcare privacy issues, including: (i) the drafting and updating of HIPAA compliance manuals; (ii) the impact of HIPAA, the HITECH Act and the Breach Notification Rule on transactions; and (iii) analyzing and drafting business associate agreements. Mr. Crapo has also evaluated and assisted in the structuring of transactions to meet the requirements of various anti-kickback laws and the Stark law. He has revised medical staff bylaws to meet changes in the Joint Commission standards and has prepared hospital access agreements. Consistent with his extensive experience in bankruptcy law, Mr. Crapo has represented creditors and potential purchasers of the assets of healthcare-related debtors.

He has written on healthcare related issues and is a co-editor of the newsletter of the Health Law Committee of the American Bankruptcy Institute. Mr. Crapo has also drafted numerous insolvency-related bankruptcy opinions in connection with corporate and municipal bond transactions and has authored or co-authored many articles on bankruptcy-related subjects.

To facilitate the development of the Gibbons Health Care practice, Mr. Crapo earned a LL.M. in Health Law and Policy.


Seton Hall University School of Law (LL.M, 2012)

University of Houston Law Center (J.D., with honors, 1984)

University of Wisconsin at Madison (M.A., 1979)

Boston College (A.B., summa cum laude, 1978)

Professional Admissions

State of Texas 1984

State of New Jersey 1991

United States District Court for the District of New Jersey 1991

United States District Court for the Southern District of New York 2003

United States District Court for the Northern District of Texas 1985

United States Bankruptcy Court for the District of New Jersey 1991

United States Bankruptcy Court for the Southern District of New York 2003

United States Court of Appeals for the Third Circuit 2000

United States Court of Appeals for the Second Circuit 2010

Professional Activities

Member, Health Law, Secured Transactions and Bankruptcy Taxation Committees of the American Bankruptcy Institute

Member, American Bar Association, Health Law Section

Member, American Health Lawyers Association

Member, New Jersey State Bar Association, Bankruptcy Law and Health and Hospital Law Sections

Member, State Bar of Texas

Lecturer, ABA Taxation Division

Lecturer, Essex County Bar Association, Creditor/Debtor Committee

Lecturer, Bench-Bar Conference of the New Jersey State Bar Association Bankruptcy Law Section, tax-related issues in bankruptcy

Lecturer, Law Education Institute, Inc., National CLE Conference in Colorado (January 2002) (on bankruptcy-remote entities)



William B.

Well presented.

Marvin W.

A very sophisticated program. I at times had a hard time following parts due to the speed and complexity of material - and I am a bankruptcy attorney. A lot to cover in a little time. Fortunately, I downloaded the materials and transcript.

Stuart H.

The speaker was clear in his presentation. Even bankruptcy impacts other areas like HIPPA .

Manish C. S.


Neville T F.

Very interesting new field opening!!!

Antonio R.

Because our firm has dealt with similar issues like this before i found it interesting.

John M.

Wow! This was great stuff!

Julie A. B.

Program shares practice tips to achieve the best result in bankruptcy for a financially troubled provider.

David S.

Great to know issues about health care bankruptcies.

Anu M.

Excellent speaker! Thank you

Matt K.

well informed

Kevin A.

Good stuff. I picked up a few items I can use going forward! Thank you.

Mieke M.


Odes L. S.


Owen K.


Alison C.

Very informative, well-presented, interesting written materials.

Douglas P.

Course written material was in concert with lecture.

Leonard G.

Excellent presentation.

Claude A.

Very comprehensive

James T.

Excellent speaker

Seth B.

Very well done.

Aubrey F.


Barbara L.

Extremely informative

Maeve T.


Mattie A.


Paul P.

Thank you.

Mitzi G.


Stephen E.

Well-organized lecturer.

Lisa C.

I meant to check topic. Very good info.

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