The Cigna Group (NYSE:CI) has agreed to pay $172M to settle allegations that it submitted inaccurate and misleading diagnosis information about its Medicare Advantage patients in order to increase its payments from Medicare.
The settlement also requires Cigna to enter into a five-year corporate integrity agreement with the Office of the Inspector General of the US Department of Health and Human Services, the agency that oversees the Medicare program.
Cigna had been accused by the federal government of violating the False Claims Act by submitting and failing to withdraw “inaccurate and untruthful diagnosis codes” for its Medicare Advantage customers in order to secure bigger payments from the government’s Medicare program, according to a statement issued by the Department of Justice on Saturday.
Under the corporate integrity agreement, Cigna will be required to implement various accountability and auditing measures, in addition to conducting annual risk assessments. Cigna’s management team and board of directors will also be required to certify Cigna’s compliance measures on an annual basis, the Justice Department said.
The Justice Department added that the claims were allegations only and that there had been no determination of liability.
“The agreements fully resolve long-running legal matters, enabling us to focus our resources on all those we serve and avoiding the uncertainty and further expense of protracted litigation,” Cigna Healthcare’s president of US government business, Chris DeRosa, said in a statement issued late Friday.