The Cigna Group (NYSE:CI) has agreed to pay $172M to settle allegations that it submitted inaccurate and deceptive analysis details about its Medicare Benefit sufferers as a way to improve its funds from Medicare.
The settlement additionally requires Cigna to enter right into a five-year company integrity settlement with the Workplace of the Inspector Normal of the US Division of Well being and Human Companies, the company that oversees the Medicare program.
Cigna had been accused by the federal authorities of violating the False Claims Act by submitting and failing to withdraw “inaccurate and untruthful analysis codes” for its Medicare Benefit clients as a way to safe greater funds from the federal government’s Medicare program, in line with an announcement issued by the Division of Justice on Saturday.
Beneath the company integrity settlement, Cigna will probably be required to implement varied accountability and auditing measures, along with conducting annual danger assessments. Cigna’s administration staff and board of administrators may also be required to certify Cigna’s compliance measures on an annual foundation, the Justice Division stated.
The Justice Division added that the claims have been allegations solely and that there had been no willpower of legal responsibility.
“The agreements absolutely resolve long-running authorized issues, enabling us to focus our assets on all these we serve and avoiding the uncertainty and additional expense of protracted litigation,” Cigna Healthcare’s president of US authorities enterprise, Chris DeRosa, stated in an announcement issued late Friday.