Cigna medicare sanction

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In an enforcement letter, CMS accused Cigna of "widespread and systemic failures," including the denial of health care coverage and prescription drugs to patients who should have received them. The actions "create a serious threat to enrollee health and safety," said CMS, which is requiring Cigna to appoint an independent monitor to audit its handling of the matter.

The sanctions, which took effect at the end of the day Thursday, do not affect patients who are already enrolled. CMS said could not provide an estimate for how many patients were affected. In other instances, we will implement the changes as quickly as possible to emerge a stronger organization further dedicated to those we serve. CMS also accused Cigna of maintaining inadequate documentation and failing to implement a risk assessment program, among other alleged violations. The deficiencies resulted in enrollees experiencing delays or denials in receiving medical services and prescription drugs, or in an increase in their out-of-pocket costs for medical services and prescription drugs.

Cigna's acquisition of HealthSpring, Inc. This breakdown in operations made it difficult for Cigna to adequately monitor and oversee whether it was in compliance with the Medicare Parts C and D requirements, CMS said.

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