Citing “an exponential increase in fraudulent and abusive” substance abuse treatment practices – and in particular drug screening- Cigna Inc. won’t be offering Florida health plans on the federal Health Insurance Marketplace when it opens for business in the next few weeks.
The decision is temporary- it affects only 2016, and only individual and family medical plans offered on the Florida public health insurance marketplace.
Plans offered off-exchange, Cigna-HealthSpring Medicare Advantage Plans and Cigna’s group health plans offered through employers and unions aren’t impacted.
In explaining the decision, Cigna spokesman Joseph Mondy cited Post articles detailing how fraudulent drug screening has reaped millions for South Florida labs, especially those affiliated with sober homes and treatment centers. In one case found by The Post, pee-in-a-cup lab work cost more than $300,000- for a single client.
The sky-high charges have exploited addicts and alcoholics seeking help, gouged insurers and spurred an FBI investigation into the area’s billion-dollar addiction treatment industry.
Lab practices go beyond ballooning charges, however. Earlier this year, Cigna sued Sky Toxicology and two affiliated lab firms in federal court here, alleging a $20 million civil fraud revolving around urine testing.
According to the suit, Sky, a consortium of labs, offered doctors and drug treatment centers ownership interests in the companies. For their investment, said Cigna, providers were paid “kickbacks in the form of dividends” linked to how many urine tests they sent to Sky.
The suit did not specify how much money Sky paid to the doctors and centers. However, two sources close to the industry told The Post that $12,500 was one investment amount and that for the $12,500, providers sending urine to Sky could get anywhere from $24,000 quarterly to $50,000 monthly.
Settlement talks in the suit are expected to get underway later this month, according to court records.