Cigna is paying over $172 million to settle claims over Medicare Advantage reimbursement

FILE - This photo shows the Cigna logo at the headquarters of the health insurer Cigna Corp., in Philadelphia on Aug 4, 2011. A federal lawsuit alleges that the health insurance giant used a computer algorithm to automatically reject hundreds of thousands of patient claims without examining them individually as required by California law. The class-action suit filed Monday, July 24, 2023, says Cigna rejected more than 300,000 payment claims in just two months last year. (AP Photo/Matt Rourke, File) (Matt Rourke, Copyright 2023 The Associated Press. All rights reserved.)

Health insurance provider The Cigna Group will pay more than $172 million over claims it gave the federal government inaccurate Medicare Advantage diagnoses codes in order to inflate reimbursement.

The case centered around allegations that Cigna violated the False Claims Act by submitting and not withdrawing “inaccurate and untruthful” codes, according to the U.S. Department of Justice.

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The department said in a statement Saturday that Cigna falsely certified in writing that its data was truthful.

Cigna said that the settlement with the government resolved a long-running legal case and “avoided the uncertainty and further expense” of a drawn-out legal battle.

Medicare Advantage plans are privately run versions of the federal government’s Medicare program mainly for people 65 and older.

Cigna also said it will enter a corporate-integrity agreement for five years with the Department of Health and Human Services inspector general office. That deal is designed to promote compliance with federal health program requirements.

Shares of Bloomfield, Connecticut-based Cigna climbed 86 cents to $286.93 in Monday afternoon trading. Broader indexes were mixed.

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