US Intervenes In Lawsuit Against Cigna alleging Medicare Fraud
America ı By Samuel Lopez
296 0 Comments
The government’s complaint comes two years later. In the complaint, Cutler detailed one instance of billing codes that were being added for chronic obstructive pulmonary disease and dementia, even though a nurse reported that the patients had no such conditions.
Cutler also claimed that Cigna trained its contractors to make fake diagnoses for rheumatoid arthritis based only on weight loss, fatigue, or symptoms of stiffness or pain. The complaint says that the government was “unaware that these claims were false and fraudulent,” and it “overpaid Cigna by more than $1.4 billion.”
The lawsuit filed by Cutler was originally filed in New York federal court, but Cigna contested jurisdiction and the case was ultimately transferred to Tennessee, against Cutler’s objections.
In August, Judge Eli Richardson of the U.S. District Court granted the government’s motion to intervene in Cutler's suit, but not before rebuking Cigna’s lawyers for their description of the anti-fraud statute’s good-cause standard arguing the government's late intervention in whistleblower complaints.
In the government's intervening complaint filed on Monday, the government claims that Cigna’s vendors visited patients at their homes and filled out a form created by Cigna that included a “check-the-box” list of a wide range of various medical conditions to select from.
The government’s complaint alleges that Cigna would then have its coding teams identify diagnosis codes that corresponded to the reported medical conditions before they submitted them for reimbursement from the Centers for Medicare and Medicaid Services.
The complaint states that Cigna used those home visits to illicit lucrative diagnosis codes that would drastically raise its monthly reimbursements from Medicare and Medicaid Services, without providing any actual medical care, and that it deceptively did not inform its policyholders of its nefarious activities.
The complaint also alleges that Cigna and its vendors specifically targeted plan members to visit at home, who it believed had the greatest risk score increases so that it could maximize the greatest increased reimbursements.
The government said that these fake diagnoses included congestive heart failure, rheumatoid arthritis, diabetes, and chronic kidney disease. The government said that Cigna pressured its vendor health care providers to record “high-value diagnoses” and closely tracked the diagnoses recorded by each vendor’s home visits.
According to the government, Cigna submitted fake diagnosis codes for tens of thousands of invalid diagnoses to Medicare and Medicaid, which resulted in the insurer receiving tens of millions of dollars in risk adjustment payments from the Centers for Medicare and Medicaid Services.
FOLLOW US
Recent Posts
Supreme Court Asked To Step In As 98-Year-Old Federal Judge…
Thomas Medlin Found Dead in Brooklyn Waters After Two-Month Search
American Refuelling Aircraft Crashed in Iraq During Military Operation
Astronomers Witness Birth of a Magnetar in Explosive Cosmic Event
Firefly Launches Alpha Flight 7 Mission Successfully from California Spaceport
Microsoft Copilot Health AI Tool Launches to Help Users Understand…
FTC Refunds for Invitation Homes: $47.2 Million Headed to Hundreds…
Don’t Miss It
Palantir and Nvidia Partnership Unveiled as AI Alliances Expand at AIPCon 9
By – Rihem AkkoucheOld Dominion University Shooting Investigated as Terrorism After Gunman Identified
By – Rihem AkkoucheGulf Travelers’ Jet Prices Soar as War Disrupts Middle East Air Travel
By – Rihem AkkoucheShooting at Michigan Synagogue Leaves Suspect Dead After Security Confrontation
By – Rihem AkkoucheStolen Military Drones And The Emerging Threat of Foreign UAV Attacks On The California Coast
By – Samuel LopezHollywood’s “Disclosure Day” And Washington’s Silence Raise Questions About Timing of UFO Transparency
By – Samuel LopezThe World Cup Security Reckoning: Trump Warns Iran Soccer Team About Safety As War Tensions Spill Into Global Sports
By – Samuel LopezScientists Identify 22 Anomalies In Interstellar Object 3I/ATLAS As It Leaves The Solar System
By – Samuel Lopez
Kelly Warner Law Firm Blames USA Herald for Arizona Bar Investigation
5/17/17 Based on the information released in The Washington Post article on 5/17/17, the USA Herald publishes another in-depth article that…
By – USA Herald
Aaron Kelly Law Firm Resorts To Attacking Former Client Again On KellyWarnerLaw.com – Pattern Recognized
Professor Volokh thereafter filed a bar complaint against Dan Warner with the Arizona Bar. This eventually led the ABA to…
By – Jeff Watterson
Arizona Bar Opens Investigation on Attorney Aaron Kelly
USA Herald recently reported on a developing story involving Attorneys Daniel Warner and Aaron Kelly. Both Warner and Kelly have…
By – Paul O'Neal
Iran Appears To Have Conducted Its First Major Cyberattack Against A U.S. Company, Since The War Began – New Front Opens Against American Healthcare
Public reporting has pointed to a likely abuse of Microsoft Intune-style device management functions. Sophos threat intelligence director Rafe Pilling…
By – Samuel Lopez
Hormuz Shock Hits U.S. Legal And Insurance Sectors As War Risk, Cargo Claims And Contract Fights Begin to Spread
The legal sector impact is just as significant, and in some ways more underreported. What experienced coverage lawyers and commercial…
By – Samuel Lopez
Beyond Gas Prices The Strait of Hormuz Crisis Could Hit Fertilizer, Plastics, Aluminum And Global Supply Chains
Plastics and petrochemicals are another underappreciated vulnerability. Middle Eastern producers ship enormous volumes of chemicals and plastics through this route,…
By – Samuel Lopez
Fani Willis Blocked From Trump Fee Fight As Georgia Judge Lets $16.8 Million Reimbursement Battle Move Forward
INSIDE THIS REPORT A Georgia judge has ruled that Fulton County District Attorney Fani Willis cannot re-enter the collapsed Trump…
By – Samuel Lopez
FBI Bulletin Raises Troubling Questions About California’s Readiness
San Diego would rank high on any common-sense list because of its naval significance. Naval Base San Diego is a…
By – Samuel Lopez
Cumulus Media Files for Chapter 11 as Radio Giant Moves to Cut Massive Debt
A Familiar Chapter in Cumulus’ Financial Story The bankruptcy marks the second time the broadcaster has sought court protection in…
By – Rihem Akkouche
Cumulus Media Files for Chapter 11 as Radio Giant Moves to Cut Massive Debt
A Familiar Chapter in Cumulus’ Financial Story The bankruptcy marks the second time the broadcaster has sought court protection in…
By – Rihem Akkouche
Gordie Howe Bridge Tolls Revealed Ahead of Spring Opening
Local Residents React to Pricing Windsor resident Dariuss Piatkoeski said the newly announced rates strike the right balance. “I think…
By – Rihem Akkouche
Nasa Satellite to Crash to Earth as Spacecraft Re-enters Atmosphere
Meteor Strike in Germany Adds to Cosmic Drama The satellite’s predicted descent comes just days after another celestial surprise. On…
By – Rachel Moore
Lux Aeterna $10M Seed Funding Fuels Ambitious Reusable Satellite Vision
Hypersonic testing On-orbit computing In-space manufacturing The startup has also signed multiple partnerships with U.S. government organizations exploring reusable spacecraft…
By – Rachel Moore
Jupiter’s Shift Direction Lights Up the Night Sky Again
A Reminder of the Solar System’s Dance For astronomers and backyard stargazers alike, Jupiter’s shift direction is another reminder that…
By – Rachel Moore
Google and Tesla Power Grid Initiative Targets Lower Energy Costs
Tech Industry Promises to Address Costs Technology companies have recently begun pledging to help prevent those costs from falling on…
By – Rachel Moore
Google and Tesla Power Grid Initiative Targets Lower Energy Costs
Tech Industry Promises to Address Costs Technology companies have recently begun pledging to help prevent those costs from falling on…
By – Rachel Moore
Medtronic to Buy Scientia Vascular in $550 Million Neurovascular Deal
Leaders See Expanded Global Impact For Scientia, the acquisition opens the door to a much larger stage. “Scientia has developed…
By – Rachel Moore
Winklevoss Twins’ Bitcoin Transfer Sparks Market Speculation
Turbulence and Strategic Changes at Gemini The Winklevoss twins’ Bitcoin transfer also comes during a period of internal transition at…
By – Rihem Akkouche
Alabama Man Fatal Shooting Death Sentence Commuted by Governor
In a rare act of clemency that halted an imminent execution, the Alabama man fatal shooting death sentence tied to…
By – Rihem Akkouche
US Consulate Shooting in Toronto Triggers National Security Investigation
Heightened Security Around Consulates Authorities said security will be strengthened around diplomatic buildings in the area, including both the U.S.…
By – Rihem Akkouche
ExxonMobil to Move to Texas in Historic Corporate Shift
Governor Praises Corporate Move Texas Governor Greg Abbott welcomed the announcement, describing the state as fertile ground for major corporations.…
By – Rihem Akkouche
Trump’s Laser Talk Sparks New Questions About America’s Secret Arsenal
On the American side, the evidence also points to a military that is pushing hard into directed energy rather than…
By – Samuel Lopez
The Northern Lights Return
The Northern Lights have a chance to be visible from several northern U.S. states on Tuesday night, forecasters at the…
By – Jackie Allen
February Unemployment Up as Job Losses Surprise Economists
According to the BLS: Producer prices rose 2.9% year-over-year through January 2026 Core PPI increased 3.6%, excluding food and energy…
By – Jackie Allen
Late-Night Attack by Venezuelan National at Florida Beach
Officials noted that the suspect had overstayed his work visa at the time of the attack. For more details on…
By – Jackie Allen
Trump’s War in Iran: Congress Confronts Escalation After U.S. Strikes
On the Republican side, most lawmakers appear to back Trump’s strategy. Sen. Tom Cotton (R-Ark.), chair of the Senate Intelligence…
By – Jackie Allen
U.S. And Israel Launch Major Strikes On Iran — What It Means For America
Continuation of military strikes if Iran persists in retaliatory attacks. Diplomacy or ceasefire negotiations if international pressure increases. A broader…
By – Samuel Lopez
ExxonMobil to Move to Texas in Historic Corporate Shift
Governor Praises Corporate Move Texas Governor Greg Abbott welcomed the announcement, describing the state as fertile ground for major corporations.…
By – Rihem Akkouche
Rhoda AI Secures $450M Funding to Power Next-Gen Industrial Robots
In a move set to electrify the robotics industry, Rhoda AI $450M funding marks one of the largest early-stage investments…
By – Rihem Akkouche
3I/ATLAS Shocks Astronomers With Fuel-Like Methanol Molecule At Extraordinary Levels
The chemistry also appears more complex than a simple release from the nucleus alone. According to the ALMA findings, hydrogen…
By – Samuel Lopez
War Abroad, Risk At Home: Why Americans Are Quietly Reviewing Insurance Policies As Global Conflicts Expand
[USA HERALD] – As the United States confronts rising geopolitical tensions and the possibility of military engagement on multiple fronts…
By – Samuel Lopez
Pentagon-Anthropic AI Dispute Explodes Into Federal Lawsuits Over AI Safety Policies
A Rare and Controversial Blacklist National security experts say the government’s designation is highly unusual. Supply-chain risk labels are typically…
By – Rachel Moore
G7 Oil Reserve Release Considered as Iran War Disrupts Global Energy Supply
A Historic Supply Shock According to analysts at consulting firm Rapidan Energy Group, the closure of the strait has triggered…
By – Rihem Akkouche
When The Files Are Finally Unsealed The Most Mind-Bending Truth May Not Be What We Expect
[USA HERALD] – There is a widespread assumption that if governments release their most highly classified files related to unidentified…
By – Samuel Lopez
Civil Rights Icon Rev. Jesse Jackson Dies at 84 As President Trump Issues Personal Tribute
Even in later years, as illness softened his voice and slowed his step, Jackson remained active. In 2021, he was…
By – Samuel Lopez
Clues to Savannah Guthrie Missing Mom’s Disappearance Found on Security System
Community Support Grows as Search Continues As the investigation intensifies, the local community has rallied around the family. Neighbors and…
By – Jackie Allen
Mike Tyson Urges Americans to ‘Eat Real Food’ in Emotional Super Bowl Ad Highlighting Health Risks
Boxing legend Mike Tyson is using his platform ahead of Super Bowl 60 to address a personal and national health…
By – Tyler Brooks
Deadly “Death Cap” Mushrooms in California Cause Multiple Deaths and Liver Transplants Amid Rare Super Bloom
California health officials are warning the public after four deaths and three liver transplants linked to the highly toxic death…
By – Ahmed Boughalleb
From Migraines to Miracles: How Becca Valle Survived a Glioblastoma Diagnosis Against the Odds
Becca Valle, 41, thought her headaches were just migraines—until a sudden, unbearable pain revealed something far more serious. In September…
By – Tyler Brooks
Cadillac Names Inaugural Formula 1 Car MAC-26 in Tribute to Mario Andretti Ahead of 2026 Australian Grand Prix Debut
Lowdon has previously spoken about Andretti’s early encouragement during the team’s formation stages, noting that the racing legend asked him…
By – Ahmed Boughalleb
Norway Tops Medal Table After Day 13 at 2026 Winter Olympics as Team USA Surges Into Second Place
With 13 days complete at the 2026 Milan Cortina Winter Olympics, Norway sits atop the overall medal standings, collecting 34…
By – Ahmed Boughalleb
Olympic Science Explained: How Figure Skaters Spin at Blinding Speeds Without Getting Dizzy
When Amber Glenn finishes her routine, the arena usually rises with her. The music builds, her blades carve a tight…
By – Tyler Brooks
Olympic Villages Run Out of Condoms at 2026 Milan-Cortina Games
Condom supplies in the Olympic Villages at the 2026 Winter Games have been temporarily depleted, the Milan-Cortina organizing committee confirmed,…
By – Tyler Brooks
Arizona Authorities Escalate Search for Savannah Guthrie’s Mom to a Criminal Investigation
USA TODAY’s live coverage: https://www.usatoday.com Pima County Sheriff’s Office: https://www.pimasheriff.org NBC News reporting: https://www.nbcnews.com As the investigation continues, officials say…
By – Jackie AllenThis early classification, however, sparked significant criticism. Advocates argue that placing aegosexuality in this category not only misunderstood the experience…
By – Jackie AllenNo posts found.
No posts found.
No comments yet. Be the first to comment!