In an effort to stamp out Medicare and Medicaid fraud and abuse, the federal government has launched a $1 billion campaign to crack down on billing errors. Even if you make honest mistakes due to incorrect billing procedures, you can wind up owing an enormous sum of money. One charge of fraud and abuse could wipe out your hard-earned personal assets!
Consider the following:
- The federal government has redirected hundreds of agents who previously investigated savings and loan improprieties to the fraud-and-abuse crackdown.
- The government is asking senior citizens to scrutinize their bills and report anything they believe is out of line.
- Whistle-blowers now stand to gain a percentage of any money the government recoups from billing errors. Disgruntled employees have a financial incentive to report you.
- When a medical billing service is charged with improper practices, every physician and medical group that uses the service comes under heightened scrutiny by the government.
According to the federal False Claims Act, a physician who knowingly bills for false or fraudulent Medicare or Medicaid charges is liable for as much as three times the overbilled amount and up to a $10,000 fine for each claim. That could easily add up to hundreds of thousands of dollars!
The SCPIE Best Defense program from The SCPIE Companies—leaders in healthcare liability insurance for 30 years —will put you in a much better position to fight any charges the government makes that involve unintentional billing errors.*
SCPIE Best Defense is available to all solo physicians and medical groups with nine or fewer physician members (subject to underwriting approval).
You Have to Have the Best Defense
Should a case involving your practice arise, you’ll need to mount the best possible defense. The "BEST" in SCPIE Best Defense stands for Billing Errors Security Team—so you’ll have an entire team on your side:
- Within the policy limits, we’ll give you access to a panel of highly qualified attorneys to represent you in this complex area of the law, and to advise you during discussions with the government to find an equitable resolution.
- If the charges against you involve unintentional billing errors and omissions, we’ll pay 90% of your defense costs—up to $1 million for solo physicians and $2 million for medical groups (nine or fewer physicians).
Without SCPIE Best Defense, you could pay hundreds of thousands of dollars in legal fees!
- Within the policy limits, we’ll reimburse you for 90% of covered awards, judgments, settlements, fines and penalties that the government levies against you.
IMPORTANT: THIS CLAIMS-MADE POLICY WILL NOT REIMBURSE YOU FOR THE AMOUNT YOU HAVE OVERBILLED THE GOVERNMENT.
- If the case warrants it, our coverage may include a defense audit of your records to give you the facts to support your position. (By having the attorney request such an audit, anything it uncovers remains strictly privileged information.) If you had to pay for the audit on your own, it could easily cost you hundreds or thousands of dollars.
Very Affordable Rates!
The peace of mind provided by SCPIE Best Defense comes at a surprisingly low cost …
Solo Physicians: $1,200/Year (Average)
Liability limit of $1 million.
Subject to underwriting approval.
Groups: $1,200/Year (Average)
Per Physician
Liability limit of $2 million; lower limits available.
Groups with nine or fewer physicians.
Subject to underwriting approval.
Financial Strength and Security
Since your security depends, in part, on the strength and stability of your insurance company, it’s important to check the financial status of any prospective insurer. SCPIE is a solid, well-capitalized professional liability insurer. Our policyholders can rest assured that whenever they need to defend their financial security and professional reputation, we’ll be there to stand by them!
SCPIE provides professional liability coverage to approximately 9,000 physicians; we also insure other healthcare providers and a variety of healthcare facilities.
SCPIE has long been an innovative leader in medical malpractice insurance, and we’ve put all of our experience and expertise into the SCPIE Best Defense program. Considering what is at stake, can you afford not to have SCPIE Best Defense?
Complete a free, no-obligation premium estimate.
Complete an online application. (California only)
Download the application in PDF format.
* Fraudulent or intentional billing errors are excluded from coverage under the policy form.
