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The Department of Justice is suing Cigna, alleging the health insurance company fraudulently mischaracterized the health of its Medicare Advantage enrollees as a way to receive higher federal payments.
The bottom line: This lawsuit comes months after the DOJ sued Anthem over similar allegations, highlighting the federal government's aggressive stance toward resolving long-standing medical coding issues within Medicare Advantage plans.
Driving the news: The DOJ's lawsuit against Cigna, which stemmed from a whistleblower who worked at a company that worked with Cigna, said the insurer created a health assessment for its Medicare Advantage members called a "360."
- These 360 reviews were used as a means to record "false health conditions" for patients, and Cigna also allegedly paid bonuses to doctors to complete a certain number of these reviews.
- Cigna did not immediately respond to questions for comment.
Flashback: Cigna's Medicare Advantage program was sanctioned in 2016 after the federal government found Cigna inappropriately denied care to its members.
