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Legal Issues Affecting Hospital Case Managers

** This session earns RN and CCM Ethics ** 
Hospital nurse case managers work in many capacities (e.g., patient advocate, coordination of care, ensuring proper utilization), and many potential legal and ethical challenges exist in carrying out these roles. This presentation will examine the various legal issues that impact a case manager's professional role, including: malpractice and negligence, scope of practice, HIPAA, and False Claims Act. This presentation will provide an overview of the causes of action that may arise against a hospital nurse case manager, and it will provide strategies that a hospital nurse case manager should implement to protect against legal liability.

  1. Explain case manager roles that may give rise to legal liability.
  2. Identify the various laws that affect the practice of a hospital nurse case manager.
  3. Describe strategies to implement to protect against liability in performing case management tasks.