An NBC News report highlights that PBMs, including Cigna’s Express Scripts, have been implicated in dramatically inflating drug prices. The report details how a sudden increase in the cost of a critical asthma inhaler—from $70 to over $500—left a patient unable to afford his medication, which ultimately contributed to his death. This case underscores a broader issue within the healthcare insurance system, where profit-driven decisions compromise patient care.

Express Scripts, a Cigna-owned subsidiary, filed a lawsuit in Arkansas to block a law that restricts pharmacy benefit managers, arguing the law would force closures and drive up costs. This legal action challenges consumer-protective regulation and is seen as an effort to preserve corporate interests over public welfare.

A proposed class action filed on May 9, 2025 alleges that Cigna violated federal HIPAA regulations and the Pennsylvania Wiretapping and Electronic Surveillance Control Act by allowing third-party tracking pixels from platforms such as Pinterest, Snapchat, and Meta to intercept patients' personal health data for corporate profit.

A U.S. District Judge in Sacramento advanced a class action lawsuit challenging Cigna's use of an automated algorithm to deny health insurance claims without the mandatory human doctor review, ruling that this practice may constitute a breach of fiduciary duty and unfair competition.

A class action lawsuit alleges that Cigna's AI system, PXDX, is used to mass deny health insurance claims as a cost-saving measure, potentially compromising the quality of patient care. The allegations point to a reliance on algorithmic decision-making with little human oversight, raising ethical concerns over prioritizing profits over individual healthcare needs.

Cigna reached a settlement with the U.S. government over allegations of falsely billing Medicare Advantage by misrepresenting patient conditions. The agreement includes a payment of over $172 million and the adoption of a corporate integrity agreement with the U.S. Department of Health and Human Services Office of the Inspector General, addressing long-standing issues in its chart review and diagnostic coding practices.

Cigna agreed to pay $172,294,350 to resolve allegations under the False Claims Act that it submitted inaccurate and untruthful diagnosis codes for its Medicare Advantage plans, thereby inflating its payments from Medicare. The settlement addresses misconduct in its chart review and home visit practices which compromised billing integrity.

Cigna has committed to expanding its political contributions reporting to include metrics that track the alignment of donations with its stated business priorities, following the withdrawal of a shareholder proposal. This move is aimed at increasing transparency and accountability in its political expenditures.