Health insurer Cigna Group has reached a settlement with the United States over allegations of overcharging the government’s Medicare Advantage program. The settlement involves 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 resolves claims that Cigna submitted false diagnoses for patients, leading to inflated reimbursements from Medicare. Prosecutors alleged that Cigna obtained tens of millions of dollars in Medicare funds between 2012 and 2019 through this fraudulent practice.

The agreement marks a resolution to a legal battle that began in October 2022 when U.S. prosecutors in Manhattan accused Cigna of engaging in deceptive practices. By misrepresenting the health status of Medicare Advantage patients, Cigna allegedly obtained Medicare funds without conducting the necessary tests. Medicare is a government health insurance program for individuals aged 65 and older. Through the settlement, Cigna aims to put the allegations behind and move forward with greater compliance and transparency in its operations.

The settlement reflects the government’s commitment to protect public healthcare programs from fraud and abuse. By holding health insurers accountable for fraudulent practices, the authorities aim to ensure the integrity and sustainability of Medicare. As part of the settlement, Cigna will make a substantial payment, signaling its acceptance of responsibility. Furthermore, the implementation of a corporate integrity agreement will require Cigna to adhere to strict compliance standards, enhancing transparency and preventing future fraudulent activities. This resolution sets a precedent for the healthcare industry, emphasizing the consequences for false claims and promoting a fair and efficient Medicare program.

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