DOJ accuses Cigna of Medicare Advantage fraud

Modern Healthcare: The U.S. Justice Department joined a lawsuit alleging Cigna Corp. exaggerated the illnesses of its Medicare members in order to obtain higher payments from the federal government.

The Justice Department claimed that Cigna and its Medicare Advantage business HealthSpring violated the False Claims Act by submitting improper diagnostic codes for payment that were based on health conditions that did not exist or were not found in any medical records. As a result, CMS overpaid Cigna by more than $1.4 billion, DOJ alleged.

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