DOJ intervenes in lawsuit against Cigna alleging Medicare fraud

Cigna created a home visit program for Medicare patients that artificially inflated government payments by intentionally incorrectly diagnosing tens of thousands of patients with serious illnesses, a lawsuit against the insurance giant alleges.

The Department of Justice (DOJ) on Monday announced its intervention in a lawsuit originally filed in 2017 by whistleblower Robert Cutler, an attorney who previously worked for a Cigna vendor, under the qui tam provisions of the False Claims Act. The DOJ seeks damages and penalties for the alleged filing of false claims resulting from visits carried out by vendors under Cigna’s “360 home visit program.”

The government also charged Cigna with using false records and making false statements, unjust enrichment, and payment by mistake, according to its intervenor complaint.