Maryland orders Cigna to stop automatic downcoding, issues $80,000 fine  - Summary - MDSpire
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Maryland orders Cigna to stop automatic downcoding, issues $80,000 fine 

Maryland’s Insurance Administration has fined health insurance company Cigna $80,000.

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In a significant regulatory action, Maryland’s Insurance Administration has imposed an $80,000 fine on Cigna for automatically downcoding evaluation and management (E/M) claims, a practice deemed unlawful as it violates state insurance regulations. The state mandates that insurers must now formally dispute claims rather than reduce reimbursements unilaterally, addressing the payment delays faced by healthcare providers. This decision not only impacts medical professionals but also serves as a critical reminder for dentists regarding the legality of claims adjustments.

Original Source(s)

Maryland orders Cigna to stop automatic downcoding, issues $80,000 fine 

  • by Olivia Anderson

  • April 7, 2026

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