Department of Justice files lawsuit against Cigna

The Department of Justice has filed a lawsuit against the health insurer Cigna for allegedly submitting $1.4 billion in false Medicare Advantage claims.  The DOJ claims that between 2012 and 2017, Cigna used improper diagnostic codes for health conditions that its members did not have, were not recorded in their medical records and were not based on clinically reliable information.  According to the DOJ, Cigna intentionally misrepresented these health conditions as part of a scheme to coax CMS into paying a higher capitated rate on behalf of Medicare beneficiaries enrolled in their Medicare Advantage plans. Read article here…

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