Regulatory risk coverage provides you legal representation for administrative actions brought by Medicare/Medicaid, medical licensing boards, credentialing reviews and actions, Professional Review Organizations, federal agencies regarding EMTALA, and the DEA.

Coverage features include:

Utilization
Addresses Medicare and Medicaid utilization and billing review proceedings, including allegations of improper documentation involving overutilization, overbilling, unnecessary services charges, and “up coding.”

Licensing
Covers state medical licensing board reviews involving potential sanctions for unprofessional conduct.

Credentialing
Covers health care provider credentialing reviews that may adversely affect existing clinical privileges, credentialing, or staff membership.

Misconduct
Provides protection for Professional Review Organization proceedings involving allegations of misconduct.