Healthicity Blog

Medicare Advantage Compliance Under the Spotlight: Lessons from Cigna's $172 Million Settlement

$172 million is a lot of money. It's also the amount that the Cigna Group recently agreed to pay to resolve allegations it violated the False Claims Act in relation to its Medicare Advantage (MA) plan...

The U.S. Department of Health and Human Services Office of Inspector General (OIG) added a large number of new items to its Work Plan in July – more than previous months. Let's take a closer look at some key highlights.

Every year, CMS increases the number of Risk Adjustment Data Validation (RADV) audits

1. $5 Million False Claims Act Settlement -

1. Medicare Advantage Provider to Pay $30 Million to Settle Alleged Overpayment of Medicare Advantage Funds –

1. Former CEO of Tennessee Pain Management Company Convicted for Role in Approximate $4 Million Medicare Kickback Scheme –

Under the Medicare Advantage (MA) program, the Centers for Medicare & Medicaid Services (CMS) make predetermined monthly payments to MA organizations