EAVESDROPPING ON THE 50-MINUTE HOUR - MANAGED MENTAL-HEALTH-CARE AND CONFIDENTIALITY

This article discusses managed care, recent case law developments, and the legal basis of confidentiality in the patient-therapist relations hip. It discusses how managed care intrudes into the confidential trea tment relationship with prospective and retrospective utilization revi ews. Some of the areas adversely impacted include public policy, the p atient-therapist relationship, and informed consent. In order to be a program in the interest of patients and not simply cost containment, m anaged care must accommodate patients' reasonable expectations of conf identiality. Suggestions are delineated for the protection of confiden tiality by managed care, including expanding the duty of confidentiali ty to managed care, obligating managed care to secure patients' inform ational privacy, obtaining informed consent to disclose as little info rmation as necessary, and involving the patient in the cost containmen t and quality assurance process.