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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 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.
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.
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 ...
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
The DMHC Help Center educates consumers about their health care rights, resolves consumer complaints, helps consumers navigate and understand their coverage and assists consumers in getting timely access to appropriate health care services. [1]
Health insurers have come under pressure as physicians claim that the pre-authorization requirements for some procedures are restrictive and increases their paperwork. "Clinicians and health plans ...
Income from self-employment and wages of single individuals in excess of $200,000 annually will be subject to an additional tax of 0.9%. The threshold amount is $250,000 for a married couple filing jointly (threshold applies to joint compensation of the two spouses), or $125,000 for a married person filing separately. [61]