Cigna to pay $172 million to settle charges it overcharged Medicare Advantage plans
CBSN
Health insurance giant Cigna will pay more than $172 million to settle federal claims that it knowingly submitted false diagnosis codes under the federal Medicare Advantage program.
Federal prosecutors alleged in a lawsuit last year that Cigna submitted inaccurate and untruthful codes for Medicare Advantage between 2016 and 2021. The U.S. Department of Justice said in a statement Saturday that Cigna violated the False Claims Act by failing to delete or withdraw incorrect codes.
"Cigna knew that these diagnoses would increase its Medicare Advantage payments by making its plan members appear sicker," said Damian Williams, U.S. Attorney for the Southern District of New York. "The reported diagnoses of serious and complex conditions were based solely on cursory in-home assessments by providers who did not perform necessary diagnostic testing and imaging."
