News & Analysis as of

CIGNA Medicare

Pietragallo Gordon Alfano Bosick & Raspanti,...

FY 2023 False Claims Act Recoveries: $2.67 Billion In Recoveries And Over $349 Million In Awards To Whistleblowers

On February 22, 2024, the Department of Justice (“DOJ”) published its annual review of cases and recoveries under the False Claims Act. Through the end of fiscal year 2023, total recoveries (across all years) under the False...more

The Volkov Law Group

Cigna Group Falls Under the False Claims Axe and Pays Over $172 Million for Abuse of Medicare Advantage Program

The Volkov Law Group on

As if corporate healthcare businesses needed an enforcement reminder, DOJ recently announced a settlement with Cigna Group for $172 million to resolve claims that Cigna exaggerated patient illnesses to extract more money from...more

Stevens & Lee

Supreme Court’s Decision in SuperValu May Benefit Defendants in False Claims Act Cases

Stevens & Lee on

Last month in United States ex rel. Schutte, et al. v. SuperValu Inc. et al, the Supreme Court unanimously held (with Justice Thomas writing the opinion) that the False Claims Act’s (“FCA”) scienter element refers to a...more

ArentFox Schiff

Investigations Newsletter: SCOTUS Denies Cert In Cases Addressing FCA Pleadings Requirements

ArentFox Schiff on

SCOTUS Denies Cert In Cases Addressing FCA Pleadings Requirements - On Monday, October 17, 2022, the US Supreme Court rejected three petitions asking the Court to resolve a circuit split regarding the Rule 9(b)...more

Sheppard Mullin Richter & Hampton LLP

Day Two Notes for the 40th Annual J.P. Morgan Healthcare Conference, 2022

The phrase “whole person health” kept echoing through the virtual hallways during the second day of the 40th Annual J.P. Morgan Healthcare Conference. Looking at the whole person – not just separate organs or body systems –...more

Mintz - Health Care Viewpoints

Lessons Learned from FCA Settlement Involving Waiver of Medicare Coinsurance Amounts

The waiver of copayments, coinsurance, and deductibles owed by patients treated by out-of-network laboratories and other providers is a hot topic in the health care industry. Despite the near absence of clear legal...more

Baker Donelson

Congress Takes Long Look at Proposed Health Insurance Mergers

Baker Donelson on

While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

Mintz - Health Care Viewpoints

OIG and MA Plan Sponsor Settle Allegations of Altering Records Submitted During Audit

Bravo Health Pennsylvania, Inc. (Bravo), a Medicare Advantage Plan Sponsor and subsidiary of Cigna Corporation, agreed to pay $225,000 to the Government for allegedly misrepresenting or falsifying information furnished to the...more

Bradley Arant Boult Cummings LLP

Courts of Appeals Continue to Limit the Government’s Aggressive False Claims Act Theories

This spring saw two significant victories for health care providers in the federal courts of appeals. In both cases, the courts rejected an aggressive government theory under the False Claims Act (FCA), the first related to...more

Baker Donelson

Court Rules That Supervision and Enrollment Issues Don't Give Rise to False Claims Act Liability

Baker Donelson on

Following the ever-growing progeny of cases holding that Medicare conditions of participation do not give rise to False Claims Act (FCA) liability, the United States Court of Appeals for the Sixth Circuit overturned an $11...more

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