Blumenthal Urges Cigna to Rescind New Policy that Burdens Healthcare Providers

[Hartford, CT] - Today U.S. Senator Richard Blumenthal wrote to Cigna Healthcare's Chief Medical Officer to express concerns over a new policy that creates onerous administrative burdens for physicians, needlessly raises costs for healthcare providers and jeopardizes patient care.

"I am writing to express serious concerns regarding Cigna Healthcare's (Cigna) new policy that would automatically reduce physician payments for high level evaluation and management service claims without a thorough review of supporting documentation. If allowed, this new policy will significantly increase administrative burdens and costs for physicians while jeopardizing patient care. I urge you to reverse this decision and instead work closely with physicians to address any billing concerns," Blumenthal said.

In July, Cigna announced it was automatically "downcoding" the billing level for certain office visits based on information reported on the claim and not on the more detailed medical record that would appropriately justify the cost of service. If physicians want to appeal the "downcode" they must file a written appeal for each claim, creating a burdensome amount of paperwork, especially for small, locally owned physician practices, that could take months to resolve.

Blumenthal urges Cigna to rescind this decision on behalf of patients and healthcare providers.

Blumenthal's full letter is available below:

September 11, 2025

Amy Flaster, MD

Chief Medical Officer

Cigna Healthcare

900 Cottage Grove Road

Bloomfield, CT

Dear Dr. Flaster,

I am writing to express serious concerns regarding Cigna Healthcare's (Cigna) new policy that would automatically reduce physician payments for high level evaluation and management service claims without a thorough review of supporting documentation.^[1] If allowed, this new policy will significantly increase administrative burdens and costs for physicians while jeopardizing patient care. I urge you to reverse this decision and instead work closely with physicians to address any billing concerns.

In July, Cigna announced that it would automatically "downcode" the billing level for certain office visits they believe were inappropriately coded. The decision will be based solely on information reported on a claim and not on the medical record that typically details the level of medical decision making or total time spent with the patient that would justify a higher billing code.^[2] How can Cigna make an appropriate and just determination without reviewing supplemental information? It is not uncommon for insurers to use algorithms or artificial intelligence software- which are prone to errors-to make these decisions, which makes this policy even more troubling.^[3] Further, Cigna is requiring physicians to file written appeals for each claim that is automatically downcoded,^[4] which means many physicians, especially those running small practices, will have to sacrifice valuable time to file paperwork disputing billing errors. This policy needlessly raises costs and threatens patient care and the stability of physician practices across the country.

On behalf of patients and healthcare providers, I urge you to rescind this ill-conceived policy and look forward to your response by September 25, 2025.

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