The United States Monday filed a lawsuit against Cigna Corporation in the US District Court for the Middle District of Tennessee for allegedly providing false patient diagnoses to receive increased Medicare payments in violation of the False Claims Act. The defendants include Cigna and its various state companies.
The complaint alleges that, while processing home assessment paperwork, Cigna technology teams submitted diagnosis codes that were more serious than the actual diagnosis or that could not be reliably diagnosed in a home assessment. The US Attorney’s Office believes that Cigna reported wrong information to receive more money from their Medicare Advantage health plans. The Centers for Medicare and Medicaid Services (CMS) pay Medicare Advantage plans monthly and give more money to companies that care for sicker people.
US Attorney Damian Williams commented, “This office is dedicated to holding insurers accountable if they seek to manipulate the system and boost their profits by submitting false information to the Government.”
Additionally, the filing includes claims for unjust enrichment and claims the government paid some money to Cigna by mistake. For these claims, the complaint asks for the maximum amount of damages allowed by law. The US seeks triple its damages plus a civil penalty for violating the False Claims Act in relief.
