Legal issues related to case management

In response to increased demands for cost-effective health care, health care providers, employers, and third-party payers have focused their attention on developing new techniques to manage utilization and contain costs while assuring quality care. These new techniques have raised concerns that increased emphasis on utilization management and other cost-containment programs might impose increased liability on the participants in such programs. This article discusses the legal implications of current trends in utilization management and cost-containment programs and offers practical suggestions as to how program participants can minimize their legal risk.