Cigna to Pay $172M – Overcharged Medicare Advantage

Cigna is settling a federal claim for knowingly submitting false diagnosis codes to Medicare Advantage plans. Investigators alleged that Cigna submitted inaccurate and untruthful codes from 2016 to 2021, violating the false claims act. In one example, federal prosecutors said Cigna submitted reimbursement documents for patients who are morbidly obese but did not submit medical records that showed their body mass index being above 35, which is a requirement for that particular diagnosis code.