As managed care expands, liability exposures also grow

As managed care grows, related liability exposures also are growing, forcing plan sponsors and health care providers to become more aware of risk management opportunities. Employers and health plans could find themselves at risk of claims ranging from denial of benefits to how managed care plans are selected. In addition, the growth of managed care under workers compensation and state Medicaid programs - neither of which falls under ERISA's protections - may prove the biggest litigation headache on the horizon for managed care providers. According to Bill Brossman of William M. Mercer Inc., courts are increasingly holding that if the case is focused on medical malpractice then the case is allowed to proceed in state court and there is no ERISA protection.