Aug 5, 2020 - Health

Whistleblower lawsuit alleges Medicare Advantage fraud at Cigna

The Cigna logo on a smartphone.
Photo: Rafael Henrique/SOPA Images/LightRocket via Getty Images

A three-year-old whistleblower lawsuit alleges Cigna fraudulently mischaracterized the health of its Medicare Advantage enrollees as a way to receive higher federal payments.

The bottom line: This lawsuit was unsealed this week, months after the Department of Justice sued Anthem over similar allegations. However, the federal government declined to intervene in this Cigna case.

Driving the news: The lawsuit against 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.

Editor’s note: This story has been corrected to show the Department of Justice declined to intervene in the case and that the lawsuit was unsealed, not new.

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