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Health insurance provider The Cigna Group will pay more than $172 million over claims it gave the federal government inaccurate Medicare Advantage diagnoses codes in order to inflate reimbursement.
The Cigna Group is an American multinational for-profit managed healthcare and insurance company based in Bloomfield, Connecticut. [2] [3] Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups (e.g., governmental and non-governmental ...
The class-action lawsuit, filed Monday in federal court in Sacramento, says Cigna Corp. and Cigna Health and Life Insurance Co. rejected more than 300,000 payment claims in just two months last year.
Representatives stress they simply administer health plans according to the terms set by the plan sponsor and note that many claims are rejected because physicians submit incomplete or incorrect ...
Recent claim experience—whether better or worse than average—is a strong predictor of future costs in the near term. But the average health status of a particular small employer group tends to regress over time towards that of an average group. [91] The process used to price small group coverage changes when a state enacts small group ...
Employers must disclose the value of the benefits they provided beginning in 2012 for each employee's health insurance coverage on the employee's annual Form W-2's. [46] This requirement was originally to be effective January 1, 2011, but was postponed by IRS Notice 2010–69 on October 23, 2010. [ 47 ]
The settlement, reached on Friday, includes a payment of about $172 million by Cigna. Cigna said it also will enter into a corporate integrity agreement with the U.S. Office of Inspector General.
An appeal is described as interlocutory when it is made before all claims are resolved as to all parties. For instance, if a lawsuit contains claims for breach of contract, fraud and interference with contractual advantage, and if there are three defendants in this lawsuit, then until all three claims are resolved as to all three defendants, any appeal by any party will be considered ...