BC Advantage - 2017 Issue 9

Professional Liability Basics Compliance Enforcement

A Medical Billing and Coder’s professional liability policy may include coverage for defense costs, civil fines, and penalties levied by Federal and State agencies that conduct audits that target billing practices, coding of healthcare services, and the accuracy of reimbursements within clinical guidelines.  When reviewing what a professional liability policy may cover in terms of a government investigation, the regulations/laws that support these investigations and or audits include the following:  STARK Law:•The STARK Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare...

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