Medefense

Medefense provides legal expense reimbursement to a physician who is subject to a disciplinary proceeding. Disciplinary proceedings could mean a review action by the Texas Medical Board (TMB), a hospital action regarding clinical privileges, actions by the Texas Department of State Health Services or the Federal Department of Health and Human Services, and non-compliance with Medicare/Medicaid regulations. In addition, reimbursement for individual federal tax audits will be included.

Medefense will reimburse the physician up to $25,000 each claim/each policy period. Medefense benefits are subject to a $1,000 deductible, with a 10% coinsurance provision (the physician will pay 10% of the legal expenses after application of the deductible). The 10% coinsurance clause will be waived if you select an attorney from a panel provided by TMLT.

The coverage for tax audits will be limited to a $5,000 maximum reimbursement.

To take advantage of Medefense coverage, policyholders should:

1. Notify TMLT as soon as you receive the initial letter from the TMB or other disciplinary authority. The policy states that a policyholder has 60 days in which to report an event or letter in order to receive reimbursement for covered expenses.
2. Consider retaining an attorney to help draft a narrative and to respond to the disciplinary authority. Upon request, TMLT can provide policyholders with a list of attorneys who have experience handling disciplinary proceedings.

Read more about Medefense coverage.