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Vaccinating Against Design and Construction Risk: A COGENCE Alliance Momentum Recap

Client Alert

Last month, COGENCE Alliance hosted a four-day conference, attended by owners, affiliates, construction managers, trades, engineers, and architects. David Scott presented and other BMD team members hosted breakout discussions on how to “vaccinate against design and construction risk.” Groups discussed new and developing risks, how to mitigate those risks, and qualities of those who best adjusted to the new and developing risks.

Aggregated Risks in 2019. In 2019, COGENCE gathered information from the six industry segments (owners, affiliates, construction managers, trades, engineers, and architects) to first identify risks from each discrete group’s perspective. Next, COGENCE ranked the identified risks to determine which risks were most significant. Finally, COGENCE worked together across industry segments to identify habits to help mitigate risks and improve projects. The ten greatest risks aggregated across industry segments included: (1) communication; (2) contracts; (3) leadership; (4) schedule; (5) budget; (6) team members; (7) changes; (8) financial; (9) quality; and (10) due diligence.

Changing Risks with COVID-19. With the onset of the COVID-19 pandemic in March 2020, some of the risks identified by the various industry segments in 2019 quickly changed. Reports from breakout rooms indicated that new and different risks were resultant of the pandemic. For example, industry segments identified new risks associated with an elevated standard of care with heightened expectations and design for occupant safety, as well as new safety and sanitation protocols. Other risks included those related to cybersecurity due to increased remote work, as well as the evolution and need (or lack thereof) for space, such as physical offices.

New Risks with COVID-19. The breakout rooms also discussed how existing risks had morphed. For example, communication, the greatest risk identified pre-pandemic, posited new challenges including Zoom fatigue, complex logistics with site visits, as well as an increase in difficulty to collaborate due to a loss of “serendipitous” communications. Other changes to existing risks included budgetary concerns, particularly relating to the cost of PPE, HVAC improvements, and WELL certifications.

Mitigating New and Changing Risks. To address the new and developing risks, the breakout rooms discussed how to mitigate certain risks, which included more frontend planning, running through project stress tests (e.g. check technology and remote access), and developing more robust onboarding protocols to integrate new team members. Other mitigation plans revolved around communication, specifically ensuring consistent communication, standardizing how teams communicate (email, videoconference, phone call, text), following up after meetings, and identifying issues early and often.

Adapting to New and Changing Risks. The breakout rooms concluded by discussing those who have been most effective in adapting to the new and developing risks of the pandemic. Groups identified that those who demonstrate care and concern for their team members, as well as those willing to seek information and consequently learn and adapt had best weathered the new challenges in design and construction.

If you have questions or need more information regarding design and construction risk, please contact Construction Law Member David Scott at dmscott@bmdllc.com (614.246.7514).


New Florida Law: Patient Overpayments Must Be Refunded Within 30 Days

Effective January 1, 2026, Florida Senate Bill 1808 requires health care facilities and practitioners to refund patient overpayments within 30 days after an overpayment is identified. The law applies to overpayments tied to claims submitted to government programs or private insurers and introduces fines and disciplinary consequences for noncompliance. Providers should review billing and payment practices now to prepare for the new requirements.

USCIS Policy Change Impacting Work Authorization: Advisory for Employers and Human Resources

USCIS has issued a policy memorandum pausing immigration benefit processing for individuals from 19 high-risk countries and requiring a re-review of certain previously approved cases. This change may affect work authorization, employment verification, and workforce stability. Employers and HR teams should review impacted employees and update compliance procedures.

CMS Releases CY 2026 Medicare Physician Fee Schedule Final Rule with Key Payment and Telehealth Updates

CMS issued the CY 2026 Medicare Physician Fee Schedule Final Rule on October 31, 2025, with changes effective January 1, 2026. The Final Rule includes increases to the conversion factor, a new efficiency adjustment, updates to practice expense methodology, permanent telehealth policy changes, revised payment for skin substitutes, expanded rules for Part B drugs and biologicals, enhanced policies for Rural Health Clinics and Federally Qualified Health Centers, and new care management and behavioral health services.

Ohio Department of Medicaid Updates: Key Changes to Physician Reimbursement Rates in Early Parenthood

The Ohio Department of Medicaid has proposed amending Ohio Administrative Code Rule related to covered Medicaid reimbursements for physicians. Beginning on January 1, 2026, they are proposing an increase to rates for prenatal care, childbirth, and infant care and provider visits.

Name, Image, and Likeness Agreements in Healthcare

For example, some healthcare providers have begun to utilize "Name, Image, and Likeness" agreements to promote the brand they have created through their healthcare practice.  We have seen the most healthcare NIL activity with longevity and wellness providers, as well as orthopedics.