Target classes
- Physician Groups
- Allied Health Facilities
- Hospitals
- Long-Term Care Facilities
- Mental Health Facilities
- Solo Physicians
- Home Healthcare Agencies
Highlights
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Billing errors coverage - Reimbursement for defense costs, fines and penalties, and shadow audit expenses incurred in billing error proceedings, including qui tam actions
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Coverage for other medical regulatory violations - Reimbursement of defense costs and fines and penalties incurred in HIPAA proceedings, EMTALA proceedings and STARK proceedings
- Broad policy language and free choice of counsel
Claims example
A qui tam action was filed against an urgent care facility alleging that the facility inflated its billings for urgent care medical services (also known as ‘up-coding’). The facility was reimbursed for over $1 million in defense costs under MEDEFENSE® Insurance.*
*Coverage is determined based on the specific facts and circumstances presented at the time of a claim and the language of the policy issued to the Insured. These fact patterns are intended only to illustrate the types of claims that may trigger coverage under a MEDEFENSE® policy.
Summary of coverage
Billing Errors Coverage
Reimbursement of defense costs, fines and penalties, and shadow audit expenses incurred in billing error proceedings brought by:
- Federal or state governmental agencies
- Qui tam plaintiffs
- Contractors working on behalf of the government, such as ZPIC and RAC
- Commercial payers
Coverage For Other Medical Regulatory Violations
Reimbursement of defense costs and fines and penalties incurred in HIPAA (Patient Privacy) Proceedings, EMTALA (Emergency Medical Treatment and Active Labor Act) Proceedings, and STARK (Physician Self-Referral) Proceedings.
For Brokers
Information about you and your business may be at risk of getting into the wrong hands. At CPLG, you are more than insured, you are prepared. Our goal is to help you make more-informed cyber protection decisions to get ahead of potential attacks. We use artificial intelligence (AI) and advanced analytic technologies to monitor your cyber environment with machine-level speed and accuracy.
Visit Cyber & Tech, for brokersFor Policyholders
It's all in the data. As a response to the ever-changing threat environment, we utilize data and artificial intelligence (AI) techniques to stay ahead of threat actors, mitigate the damage they cause by identifying and cataloging daily attack vectors measured in real time against client vulnerabilities. Explore to learn more.
Visit Cyber & Tech, for youDocuments & forms
- MEDEFENSE® Plus Insurance ApplicationView PDF
- MEDEFENSE® Plus Insurance Renewal ApplicationView PDF
- e-MD® / MEDEFENSE® Plus Insurance ApplicationView PDF
- e-MD® / MEDEFENSE® Plus Insurance Renewal ApplicationView PDF
- Summary of Changes View PDF
- e-MD® / MEDEFENSE® Plus Insurance PolicyView PDF
- MEDEFENSE® Plus Highlight SheetView PDF
- MEDEFENSE® Plus and e-MD Highlight SheetView PDF
- CPLG Premier Protection from Cyber ThreatsView PDF
- Cyber Pre-Breach & Post-Breach Response ServicesView PDF
- Cyber GlossaryView PDF
Not all products, coverages, or features may be available in all states. Restrictions, exclusions, limitations, and conditions apply and you should see your agent for more information. Certain products and services are provided through non-admitted insurance carriers and are not subject to certain State Guaranty Funds.