Even the most comprehensive insurance plans can have gaps in coverage, and these often occur when a company has unique service lines or exposures that do not fall under traditional insurance coverages.
Health care providers and payers are at risk in several ways due to the unique nature of their operations. From financial exposures due to government billing to the high standards of data privacy and security due to HIPAA requirements, these organizations have exposures that can easily lie outside regular coverage.
Dubraski & Associates has the insurance industry background, combined with decades of health care-specific experience, to assess an organization’s unique needs, and then identify any coverage areas where more or better coverage may be required. These include:
- Data Privacy & Network Security
- Environmental Liability
- Government Billing Errors & Omissions
- Miscellaneous Errors & Omissions
Data Privacy & Network Security
Because of HIPAA and other state, local and federal privacy laws surrounding patient information, health care organizations have to meet very high standards for data maintenance, security and transmission. At the same time, they are more vulnerable than ever to security breaches. In fact, the Privacy Rights Clearinghouse reports that more than 600 million records have been compromised due to data breaches since 2005.
With that in mind, it is essential that these hospitals, senior living facilities, other providers and all types of managed care organizations have comprehensive data privacy and network security insurance coverage. These policies protect against liability for the breach of protected health information due to many incidents, such as hacking, lost laptops or other portable devices, lost or damaged paper records, negligent employees, and more.
In addition, these policies provide first-party coverage, which means they cover the policyholder for a variety of expenses. These coverages include reimbursement for the costs to manage a data breach if and when one occurs, covering:
- Credit monitoring and identity theft resolution
- Notification costs
- Forensic expenses
- Legal expenses
- Data restoration expenses
- Crisis management and public relations services
- Business interruption expenses
Technology moves fast, and data storage/retrieval platforms are changing faster than ever. In addition, the health care industry is under constant regulatory scrutiny over the protection of patient data. Dubraski & Associates has the background and experience necessary to provide proper guidance in how to manage and transfer the risk of health care data security.
Health care facilities house a wide variety of hazardous materials used for diagnosis, treatment and cleaning. These materials pose a significant exposure to health care organizations if they are not handled and disposed of properly. Specialized Environmental Liability insurance policies have been developed to help health care organizations manage their environmental exposures.
These policies protect a provider and facility against liability from the accidental release of:
- Pollution conditions on, at or migrating from the health care organization against claims arising from: waste to offsite locations, and tendering waste to non-owned offsite disposal or recycling facilities.
- Fungal and legionella exposures
- Decontamination costs resulting from facility-borne illness events
- Emergency response costs
- Catastrophe management costs
- Business interruption losses
Not having this type of coverage in place leaves a gap that could cost a health care facility or provider millions of dollars in cleanup and related costs. Dubraski & Associates can look at your specific areas of risk, and recommend the proper type and balance of coverages necessary to provide full coverage.
Government Billing Errors & Omissions
Health care providers today face constant scrutiny over billing practices related to health care reimbursement. For example, CMS launched the Recovery Audit Program was implemented in order to identify and amend improper Medicare payments in order to prevent future errors and ensure payment compliance. These audits and maintain compliance is a significant administrative task and can ultimately lead to costly payment denials and other expenses.
Government Billing Errors & Omissions insurance was created to address the potentially significant exposure providers face with regards to defense expenses and audit/investigation costs related to regulatory violations of medical billings. This insurance not only provides affirmative coverage for these specific circumstances but also can fill gaps in other insurance policies, such as Directors & Officers Liability and Managed Care Errors & Omissions Liability.
To learn more about specialty insurance solutions at Dubraski & Associates, contact us.