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The Federal Government is not alone in the increasing scrutiny of physician practices for billing violations. State Medicaid agencies and commercial insurance companies are launching aggressive efforts to enforce billing compliance. Additionally, increased regulation has required physician practices to spend more time on complicated administrative issues creating new liability challenges.
Physicians are legitimately concerned that a single unintentional violation of one of the many regulations can bankrupt their practice.
Below are some of the more common regulatory issues that physicians face today and how the program responds:
Medicare / Medicaid Audit Coverage
EXPOSURE: Government allegations of fraud
FFActsplus provides defense and indemnity covering fines and penalties for physicians involved with Medicare / Medicaid audits.
HIPPA Compliance
EXPOSURE: Patient privacy regulations
New rules governing the restricted use of patient information have recently created a new liability exposure for healthcare providers. Enforcement activity for non-compliance may become an additional challenge for physician practices that are governed by these regulations. FFActs plus provides defense and indemnity protection for fines and penalties levied by Federal or State enforcement agencies as a result of allegations of HIPAA regulatory violations.
Commercial Payor Audit Coverage
EXPOSURE: Commercial payor allegations of fraud
FFActsplus expands coverage beyond governing mental audits to provide defense costs for commercial payor investigations for billing fraud.
STARK Coverage
EXPOSURE: Patient privacy regulations
New rules governing the restricted use of patient information have recently created a new liability exposure for healthcare providers. Enforcement activity for non-compliance may become an additional challenge for physician practices that are governed by these regulations. FFActs plus provides defense and indemnity protection for fines and penalties levied by Federal or State enforcement agencies as a result of allegations of HIPAA regulatory violations.
Commercial Payor Audit Coverage
EXPOSURE: Commercial payor allegations of fraud
FFActsplus expands coverage beyond governing mental audits to provide defense costs for commercial payor investigations for billing fraud.
STARK Coverage
EXPOSURE: Non-Compliant referral agreements
FFActsplus extends coverage to provide defense and indemnity (covering fines and penalties) for providers that are investigated for allegations of STARK violations.
EMITALA
EXPOSURE: Emergency Medical Treatment
Physicians that are involved in emergency medicine have regulatory exposure under the Emergency Medical Treatment Active Labor Act (EMTALA). Fines and penalties associated with the violations of the act can run in the hundreds of thousands of dollars. FFActs plus provides defense and indemnity coverage if allegations of non-compliance are made against physicians who provide emergency medical care.
To learn more about Beazley Breach Response for Physicians Products
Contact Scott Hershkowitz: 732-747-0800 Ext. 151