- The Department of Justice (DOJ) filed a lawsuit against Cigna, alleging it made tens of millions of dollars by making certain Medicare Advantage (MA) patients seem sicker than they actually were. According to the lawsuit, Cigna structured home visits for the primary purpose of capturing and recording lucrative diagnosis codes and targeted individuals for home visits who were likely to yield the greatest risk score increases and thus the greatest increased payment. The lawsuit resulted from a whistleblower complaint and seeks damages and penalties. (Press release here; Articles here, here, and here)
October 18, 2022
Payers