Cigna Group Settles Fraud Lawsuit, Agrees to $37 Million Payment for Overcharging Medicare Advantage Program

The United States has reached a $37 million settlement in a healthcare fraud lawsuit against Cigna, accusing the company of submitting false and invalid patient diagnosis codes to inflate its Medicare Advantage payments. The lawsuit alleged that Cigna used vendors to conduct in-home assessments of plan members, but the diagnoses provided were not supported by proper testing or imaging and were often not reported by any other healthcare provider. As part of the settlement, Cigna admitted to certain conduct and agreed to implement accountability measures. The company also resolved separate allegations of submitting invalid beneficiary diagnoses to inflate Medicare Advantage payments.