HealthExec May 2, 2024
A former medical director at Cigna is blowing the whistle about a policy to “deny, deny, deny” claims, in an effort to hit performance metrics even if it meant patients would be unable to receive necessary care.
Debby Day, MD, said she was given extensive power by the insurer to approve or reject requests for life-saving care, such as drugs and surgeries. Day’s job at Cigna was to review cases flagged for denial, a process that took time, requiring review of medical literature to ensure denying treatment was the right thing to do—and often, it wasn’t.
In a story in ProPublica, Day said she worked for Cigna for more than 15 years and was eventually told she needed...
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