Cigna Group to Pay $172 Million for Medicare Advantage Fraud

Health insurance provider, The Cigna Group, has agreed to pay over $172 million as part of a settlement, following allegations of providing inaccurate Medicare Advantage diagnoses codes to the federal government. The U.S. Department of Justice accused Cigna of violating the False Claims Act by submitting and failing to withdraw these "inaccurate and untruthful" codes. Cigna had falsely certified in writing that its data was truthful.

By reaching this settlement, Cigna has put an end to a long-running legal case, thus avoiding the uncertainty and additional expense of a prolonged legal battle. The company has taken responsibility for its actions and acknowledges the need to promote compliance with federal health program requirements.

Medicare Advantage plans are privately-run versions of the federal government's Medicare program, tailored primarily for individuals aged 65 and older. As part of the settlement, Cigna has also entered a five-year corporate integrity agreement with the Department of Health and Human Services inspector general office.

Despite the settlement, Cigna's stock price experienced a slight increase of 0.5%, reaching $286.93 on Monday. Meanwhile, broader indexes demonstrated mixed results.

Conclusion

The Cigna Group has reached a resolution in a legal case regarding Medicare Advantage fraud, agreeing to pay $172 million. Avoiding a protracted legal battle, the company will now move forward under the scrutiny of a corporate integrity agreement to ensure compliance with federal health program requirements.