Cigna Settles $172 Million Medicare Advantage Fraud Case
Health insurer Cigna has agreed to pay over $172 million to settle allegations of fraud related to inaccurate diagnoses submitted for its Medicare Advantage members. The settlement follows a government investigation into the coding practices of Medicare Advantage insurers and a whistleblower lawsuit against Cigna. The lawsuit claimed that Cigna's home visit program generated false and invalid diagnosis codes for complex conditions that require extensive testing or imaging, which cannot be reliably diagnosed in a home setting.