Health insurer Cigna Group has reached a settlement with the United States government over allegations of overcharging the Medicare Advantage program. According to prosecutors, Cigna manipulated patient diagnoses to make them appear more ill than they actually were, leading to inflated reimbursements from Medicare. The settlement includes a payment of approximately $172 million by Cigna and the implementation of a corporate integrity agreement with the U.S. Office of Inspector General.
The settlement, finalized on Friday, concludes a case that originated in October 2022, when U.S. prosecutors in Manhattan accused Cigna of fraudulently obtaining tens of millions of dollars in Medicare funds between 2012 and 2019. It was alleged that Cigna submitted false diagnoses for patients without conducting the necessary tests. Medicare is a government health insurance program for individuals aged 65 and older.
As part of the settlement, Cigna will make a significant payment and comply with a corporate integrity agreement, which will likely involve enhanced monitoring practices and oversight by the U.S. Office of Inspector General. This settlement demonstrates the government’s commitment to combatting healthcare fraud and ensuring the integrity of federal programs like Medicare. The resolution of this case serves as a deterrent to other healthcare companies engaged in fraudulent practices and sends a message that companies will be held accountable for their actions.