From Name

From Email

To Name

To Email

Message

Fraudulent coding led CMS to overpay Cigna $1.4 billion, Justice Department says

from Becker's Hospital Review

Fraudulent coding led CMS to overpay Cigna $1.4 billion, Justice Department says Becker's Hospital Review The U.S. Justice Department accused Cigna of using improper diagnostic codes to artificially inflate reimbursement for its Medicare Advantage plans by $1.4 billion in a lawsuit. The 64-page lawsuit, filed Aug. 4 in the U.S. District Court for the Southern District of New York, claimed that from 2012 until 2017, Cigna's HealthSpring unit, which runs Medicare plans, submitted false risk adjustment claims to CMS that led to improper reimbursement increases. The Justice Department accuses Cigna of submitting codes for conditions that its Medicare Advantage members didn't have, weren't recorded in medical records or weren't based on clinical data. READ MORE

more