Aetna to pay $117.7M to settle Medicare Advantage upcoding allegations: DOJ

fiercehealthcare - Aetna has agreed to pay $117.7 million to settle allegations that it submitted false or inaccurate diagnoses to juice Medicare Advantage payments.

AI Summary: CVS Health (via its Aetna unit) agreed to a roughly $118 million settlement with the DOJ to resolve False Claims Act allegations that inaccurate diagnosis submissions inflated Medicare Advantage payments. The deal closes a chapter on federal scrutiny of coding practices and aims to avoid years more of litigation and bad headlines.