Cigna Settles Medicare Reimbursement Case For $172 Million

( – The U.S. Department of Justice is seeking funds from healthcare provider Cigna as they violated the False Claims Act by charging inaccurately. Cigna noted that the settlement with the government is being handled to avoid a long, drawn-out litigation process.

Medicare Advantage plans are privately handled in conjunction with the federal government’s Medicare program for people over 65 years old. Cigna will also enter into a five-year integrity agreement with the Department of Health and Human Services. The agreement is meant to promote compliance with federal health program requirements.

Allegations of unsupported diagnoses, upcoding, pushing for high-value procedures, and false documentation will cost Cigna millions of dollars, but the stock price is holding steady. Some experts are confident that the coming years of Cigna will be well monitored for oversight but shouldn’t affect profitability.

In 2020, the Department of Justice filed a lawsuit for $1.4B by submitting diagnostic codes for conditions that patients did not have, defrauding Medicare and Medicare Advantage.

Cigna is a publicly traded company founded in 1982 and has a revenue of over $180 billion as of 2022. It is considered the 15th company in the Fortune 500 list of largest U.S. companies by total revenue. Primarily a US corporation, they selectively participate in international business and insurance ventures.

Overall, it appears that Cigna could use some assistance in handling Medicare and Medicare Advantage, as this issue is not the only problem that has arisen in recent years. Medicare was implemented in 1965 to aid in caring for the elderly and those in dire need of medical care. People and companies who choose to abuse such a system need to be punished as they are choosing to abuse those most vulnerable. The DOJ should be applauded for their tireless efforts in these matters.

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