Ironshore Announces News Managed Care Liability Cover

HAMILTON, Bermuda—Two health care-related errors and omissions programs, one for managed care organizations and the other for medical billers and coders, have been launched.Ironshore Inc. said Wednesday that its specialty health care unit, IronHealth, has expanded its government billing E&O product suite to include a tailored policy form for managed care organizations.

Separately, underwriting manager NAS Insurance Services Inc. said it has launched an E&O program for medical billers.

Ironshore product

Hamilton, Bermuda-based Ironshore said its new product is similar to its health care provider policy form and is designed as a policy option to provide flexible coverage to protect managed care organizations during in-depth government audits and investigations of their Medicare and Medicaid billing practices.

In addition, the existing health care provider form and the new form have been enhanced to allow integration with other coverage that an organization may purchase, specifically managed care E&O for managed care organizations as well as directors and officers liability coverage for health care providers, the insurer said in a statement.

Ironshore said federal prosecutors had 1,787 pending health care criminal fraud investigations involving 2,977 defendants last year. They negotiated about $2.5 billion in judgments or settlements and returned more than $18 billion to the Medicare Trust fund.

A programlaunched by the Centers for Medicare and Medicaid Services in January 2010 aims to identify and recover improper Medicare payments to fee-for-services programs and health care providers through automated and human reviews to determine the medical necessity of procedures.

NAS product

Encino, Calif.-based NAS said components of its program include coverage for third-party claims arising out of a wrongful act in the performance of, or failure to perform, medical billing and coding services; coverage for defense costs and fines and penalties from governmental and private payer allegations of improper billing; and coverage for network security and privacy liability, customer notification and credit monitoring expenses, regulatory fines and penalties, data recovery costs and multimedia liability.

In a statement, NAS said it has full binding authority to underwrite on behalf of Lloyd’s of London, London-market companies and other highly rated insurers.