Oct 21, 2022
More on Compliance & Legal
Top Stories: DOJ accuses Cigna of fraudulent MA reimbursement; Calm debuts mental health product
Also this week, the end of the public health emergency could have ramifications for telehealth.
Photo: Blanchi Costela/Getty Images
Medicare Advantage is a popular offering among insurers, but it's landed Cigna in hot water with the feds. What happened? We'll get to the bottom of that and other topics in this week's Top Stories, including a new mental health product debuting from Calm, and the ramifications the end of the public health emergency could have on telehealth.
For more news and features from Jeff Lagasse, visit Healthcare Finance News.
Talking points:
- The lawsuit seeks damages and penalties under the False Claims Act for the submissions, which the DOJ claims was used to artificially inflate the payments Cigna received for its MA coverage.
- Cigna rejected the allegation and said it was proud of its offering, but the DOJ singled out in-home assessments of plan members as an area of potential fraud.
- Calm Health, will include condition-specific programs that are "designed to bridge the gap between mental and physical healthcare."
- Calm Health will also include tools for communication with providers and caregivers as well as medication tracking.
- Ending the PHE could result in the loss of Medicaid to millions when states review enrollee eligibility and in other impacts to healthcare operations.
More about this episode
DOJ sues Cigna over alleged Medicare Advantage overpayments
Calm announces clinical mental health offering
What an eventual end to the PHE would mean for telehealth
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
