Maryland orders Cigna to stop automatic downcoding, issues $80,000 fine  - Takeaway - MDSpire
Clinical Guidelines

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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  • 1

    Maryland's Insurance Administration fined Cigna $80,

  • 2

    Cigna's practice of automatic downcoding E/M claims is unlawful.

  • 3

    Insurers must formally dispute claims rather than reduce them unilaterally.

  • 4

    E/M codes reflect the complexity of patient visits.

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    The case restores a clear process for providers.

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    It highlights scrutiny over automated claims adjustments.

  • 7

    Implications extend to dental claims as well.

Original Source(s)

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

  • by Olivia Anderson

  • April 7, 2026

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