MEDEFENSE® Plus unique coverage including:

• Coverage for actual or alleged billing errors

• Reimbursement of defense costs, fines and penalties, and shadow audit expenses incurred in billing errors 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.​

• Broad policy language and free choice of counsel

 

• Payment for pre-approved shadow audits available

 

• Voluntary Self-Disclosure – Coverage for when an Insured discloses information, without inquiry, to a government entity or commercial health insurance payer, which may serve as grounds for a regulatory proceeding against an Insured.  The information disclosed must have become known to the Insured fortuitously and subsequent to the initial effective date of this insurance.