MEDEFENSE® Plus

MEDEFENSEĀ® Plus is an innovative, effective and highly valuable reimbursement insurance product designed to help healthcare professionals address the unique regulatory exposures they face, such as billing errors proceedings brought by the federal government or private payers, as well as HIPAA violations and other medical regulatory violations.

Highlights

  • Billing Errors Coverage - Reimbursement for defense costs, fines and penalties, and shadow audit expenses incurred in billing error proceedings, including qui tam actions
  • 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

Best For

  • Physician Groups
  • Allied health facilities
  • Hospitals
  • Long term care facilities
  • Mental health facilities
  • Solo physicians
  • Home healthcare agencies

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.

Why Tokio Marine HCC?

Tokio Marine HCC is a leading specialty insurance group with offices in the United States, the United Kingdom, Spain and Ireland, transacting business in approximately 180 countries and underwriting more than 100 classes of specialty insurance. Our products and capabilities set the standard for the industry, and many of our almost 3,000 employees are industry-leading experts. Each of our highly entrepreneurial businesses are equipped to underwrite special situations, companies and individuals, and acts autonomously to deliver effective solutions.