Cigna withdraws from Fla. marketplace, blames fraud and abuse

Hartford, Conn.-based Cigna is pulling its Florida plans from the federal health insurance marketplace, according to Health News Florida.

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Cigna officials revealed the decision to some Florida insurance brokers through an email and said customers will be notified through mail beginning this week. Cigna blamed soaring costs in its Florida health insurance plans on fraud and abuse in “out-of-network substance abuse clinics and labs,” according to the report. Abusive practices cited include kickbacks or referrals for excessive testing.

“We have experienced an exponential increase in fraudulent and abusive care delivery practices in 2015 in Florida,” said Cigna spokesman Joseph Mondy, according to Health News Florida.

Those who are covered by Cigna through Medicare or an employer-sponsored group plan or union will not be affected by the move. The decision applies only to 2016 health plans for individuals and families that would have been sold on HealthCare.gov beginning Nov. 1, according to the report.

Currently, approximately 30,000 Floridians are enrolled in 2015 Cigna plans through the federal marketplace. There is no immediate impact on these customers, according to Mr. Mondy. 

Individuals can still enroll in Cigna plans through an insurance agent, but enrollment through the federal marketplace is the only way to obtain premium tax credits.

More articles on payer issues:
Day 1 of Medicare open enrollment: 8 things to know
Health insurers in the news: Week in review Oct. 9-15
Mayo Clinic Health System, BCBS of Minn. enter agreement

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