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Medicare Advantage is a popular service among insurance companies, but Cigna has caught the attention of the FBI. what happened? In this week’s Top Stories, we cover the truth and other topics such as new mental health products debuting from Calm and the impact the end of the public health emergency may have on telemedicine.
For news and feature stories from Jeff Lagasse, visit Healthcare Finance News.
- The lawsuit seeks damages and penalties under the False Claims Act for Submissions, which DOJ alleges were used to artificially inflate payments received by Cigna for MA compensation.
- Cigna denied the allegations and said it was proud of the proposal, but the DOJ cited at-home evaluations of plan participants as an area of potential fraud.
- Calm Health includes state-specific programs “designed to bridge the gap between mental and physical health care.”
- Calm Health also includes tools for communication and medication tracking with providers and caregivers.
- Terminating PHE could result in the loss of millions of Medicaids as states review registrant eligibility, and may affect other health care operations.
Details of this episode
DOJ sues Cigna for alleged Medicare Advantage overpayment
Calm Announces Clinical Mental Health Offerings
What the eventual demise of PHE means for telemedicine
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