What is Managed Care Liability?
Lawsuits brought by patients against managed care entities fall into two categories: 1) challenges to quality of care or claims of provider malpractice, and 2) assertions that medical treatment was improperly denied. KP has a long history of defending the first type of claim through its Risk Management or Medical Legal departments and defending the second type of claim through its Contract Administration department. Recently, however, these two types of claims have been combined into the same lawsuit, thereby enabling the plaintiff to “dehumanize” the error and thus inflame the sentiments of the jury so that it “sends a message” that such care or treatment will not be tolerated in future cases. If the jurisdiction allows punitive damages, plaintiffs tend to seek these; if punitive damages are not allowed or are severely restricted, plaintiffs tend to use the same argument to increase the amount of the award.
