The COVID-19 pandemic brought major disruptions to the healthcare industry. From staffing shortages to shifting policies, few areas were left untouched. Now that the crisis has eased, a wave of legal disputes is emerging. Providers, insurers and patients are facing new challenges tied to contracts, regulations and changing models of care.
Understanding these evolving issues is key to reducing risk and managing conflict.
Contract disputes and force majeure
Many providers faced delays or shutdowns during the pandemic and pointed to “force majeure” clauses, which are contract terms that excuse nonperformance due to unexpected events. But not all disruptions qualify, and courts are examining these clauses closely. In some cases, providers and payers disagree on whether COVID-19 falls under this protection. To avoid future conflict, healthcare organizations should review and clarify contract terms related to emergencies.Well-defined clauses reduce the chance of drawn-out legal battles.
Regulatory changes and compliance risks
During the public health emergency, temporary rules expanded telehealth, changed reimbursement policies and eased some compliance requirements. Many of those rules are now being rolled back or replaced, creating confusion in billing and operations.
Disputes often arise when parties interpret the rules differently. Providers may continue using billing codes or workflows that are no longer allowed. Staying current with federal and state regulatory changes is essential to avoiding accidental violations.
Telehealth challenges
Telehealth use expanded rapidly during the pandemic. While it made care more accessible, it also introduced new legal risks. Disagreements now include cross-state licensing issues, coverage denials and concerns about privacy.
Healthcare providers should ensure they are properly licensed in every state where their patients live. They also need to confirm that their telehealth platforms comply with data security and HIPAA regulations.
Liability and standard of care
Pandemic conditions stretched healthcare systems, sometimes impacting patient outcomes. Some patients are now filing malpractice claims tied to delayed procedures, limited staffing or emergency care decisions made under pressure.
Courts may consider difficult circumstances, but that is not guaranteed. Providers should document care decisions carefully and follow clear protocols to help defend against liability claims.
Alternative dispute resolution
Legal proceedings can be time-consuming and costly. For many healthcare disputes, alternative dispute resolution methods like mediation or arbitration offer a faster and more private option. These approaches can be especially useful for contract and billing issues, and can help to limit class actions.
Healthcare disputes are becoming more common in the wake of COVID-19. Changing regulations, evolving care delivery and unclear contract language all contribute to the legal challenges. By reviewing existing agreements, tracking regulatory updates and seeking legal guidance early, healthcare providers and payers can stay ahead of risk and focus on patient care.
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