CIGNA Compliance

CIGNA Step-by-Step Compliance Dispute Procedure

Listed below are the steps for a physician to take if he or she believes that CIGNA has violated the terms of the Settlement Agreement.

  1. Any physician who has not opted out of the settlement or any signatory medical society who has been asked by the physician to pursue the matter, may file a compliance dispute to the Compliance Dispute Facilitator (the "Facilitator"), Deborah Winegard.
  2. A number of Medical Societies have signed on to the Settlement Agreement and can assist you with this process. A list of signatory and additional signatory Medical Societies is available at www.hmosettlements.com
  3. The compliance dispute form is available on www.hmosettlements.com or by calling the toll-free number of the Facilitator which is 1-877-7600157.
  4. The form must be completed by the physician or his office staff, and the form must include the physician's signature. The physician should describe using specific facts, the health plan's conduct which he or she believes constitutes a material breach of the health plan's obligation under Section 7 of the Agreement. The physician should also specify which provision of Section 7 has been breached, and describe how he or she has been harmed by the breach.
  5. The physician should attach to the form any supporting documentation, including any correspondence between the physician and health plan, and any records which the physician believes are relevant for the Facilitator to determine the merits of the complaint.
  6. The completed form and attachments should be mailed to the Compliance Dispute Facilitator at the address below. No fee is required.
  7. After the Facilitator receives the compliance dispute form, the Facilitator will contact the physician to advise whether the form is properly completed, and the Facilitator will advise the physician on whether in the Facilitator's opinion, the alleged wrongful conduct is a compliance dispute.
  8. The Facilitator will prosecute the dispute on the physician's behalf without charge, and keep the physician informed as the compliance dispute process takes its course.
  9. The address for the Facilitator is:

    Deborah J. Winegard
    c/o Doffermyre Shields Canfield Knowles and Devine
    1355 Peachtree St. Suite 1600
    Atlanta, GA 30309
    (404) 881-8900 (telephone)
    (404) 881-3007 (fax)
    dwinegard@gmail.com