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Aetna Settles $117.7M Medicare Fraud Claims Allegations

3/12/2026

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Summary

Story summary

Aetna agreed to pay $117.7 million to settle False Claims Act allegations that it submitted false diagnosis codes inflating Medicare Advantage payments.
The U.S. Department of Justice announced the settlement, stating the coding inaccuracies violated the False Claims Act.
Claims covered 2018 through 2023 and followed a whistleblower lawsuit filed in 2024.
Aetna said it disagrees with the allegations and views the settlement as a means to avoid prolonged litigation.

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Story summary

Aetna agreed to pay $117.7 million to settle False Claims Act allegations that it submitted false diagnosis codes inflating Medicare Advantage payments.
The U.S. Department of Justice announced the settlement, stating the coding inaccuracies violated the False Claims Act.
Claims covered 2018 through 2023 and followed a whistleblower lawsuit filed in 2024.
Aetna said it disagrees with the allegations and views the settlement as a means to avoid prolonged litigation.