Firm News
Partner Jolie Apicella Quoted in Health Payer Intelligence Article on Cigna’s False Claims Act Settlement
On October 24, 2023, Partner Jolie Apicella was quoted in the Health Payer Intelligence article titled, “What Cignaโs FCA Settlement Means for Other Medicare Advantage Plans.”
Regarding Cigna’s recent False Claims Act settlement, Jolie states, “This case is capturing a lot of attention for two reasons. One, itโs a large settlement. The other reason is that Medicare Part C itself is big. Itโs a large portion of what the government is paying now.โ Jolie continues with, โWeโve already seen how litigation relating to Medicare Advantage plans in the last two years has increased dramatically, and Medicare Part C [spending] is going to exceed traditional Medicare in the next five years or so. Wherever there are lots of dollars going out, thatโs where the government will turn its attention to try and investigate fraud and capture back some of that money that shouldnโt have gone out.โ
Jolie also comments on CMS’s use of the Medicare Rick Adjustment Data Validation (RADV) program to identify improper overpayments and says, “Itโs good for the beneficiary to have these capitated payments in terms of making sure there is enough money to provide for their care. It can be good for CMS to have the right amount of risk for each [beneficiary] and a more personalized solution.”
To read the article, click here.
