The Maryland Insurance Administration issued Cigna an $80,000 fine and is requiring the insurer to stop automatic downcoding under a recent policy, according to a March 13 letter. Cigna’s evaluation and management policy allows the insurer to adjust some higher-level…
Legal
A former Humana employee filed a class-action lawsuit March 17 alleging the insurer improperly deducted a tobacco surcharge as part of its medical coverage, according to a court filing in the U.S. District Court for western Kentucky. The complaint said…
HHS is investigating 13 states over potential violations of a federal conscience protection law tied to abortion coverage. HHS’ Office for Civil Rights launched the investigations under the Weldon Amendment, which prohibits federal, state or local governments from discriminating against…
A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny Medicare Advantage members post-acute care. The March 9…
UnitedHealthcare and AARP are facing a lawsuit regarding alleged Medicare supplement denials, according to a Feb. 22 complaint filed with the U.S. District Court for New Jersey. The organizations collaborate on a handful of AARP-branded insurance products, including Medigap plans.…
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On March 8, a judge for the U.S. District Court in Connecticut approved a preliminary injunction against Aetna, ordering the insurer to alter its gender-affirming care policy for two plaintiffs. Several transgender women sued Aetna in 2024 over denied gender-affirming…
Payers have faced state penalties in 2026 for slow reimbursements, mishandled member complaints, and mental health parity violations. Fines in 2025 are here. Payers fined by states in 2026: 1. Aetna was fined $550,000 by Pennsylvania in March following a…
Minnesota filed a lawsuit against CMS and HHS, as well as their respective leaders, Mehmet Oz, MD, and Robert F. Kennedy Jr., regarding $243.8 million in deferred Medicaid funds, according to March 2 documents filed through the U.S. District Court…
Pennsylvania issued Aetna a $550,000 fine following a market conduct exam that found violations in mental health parity laws, according to a March 3 news release. The Pennsylvania Insurance Department reviewed Aetna’s activity from Oct. 1, 2021, through Dec. 31,…
An investigation into former CalOptima Health board member and chair Andrew Do found no fraud during his tenure, the insurer said in a Feb. 18 news release. In 2025, Mr. Do — previously an Orange County supervisor — was sentenced…