The Sidney Hillman Foundation announced Wednesday that Maya Miller and David Armstrong of ProPublica and Patrick Rucker of The Capitol Forum are the winners of April’s Sidney Award for their investigation “How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them.” The Sidney is awarded monthly to an outstanding piece of journalism.
The three reporters found that the insurance company Cigna had developed an algorithm that allowed company doctors to reject claims without ever opening a patient’s file. In many states, regulators require that company doctors conduct a full and impartial review of claims before issuing a denial. But the reporters found that in two months in 2022, Cigna doctors rejected over 300,000 claims, spending an average of 1.2 seconds on each.
“We literally click and submit,” one former Cigna doctor told the reporters. “It takes all of 10 seconds to do 50 at a time.”
When asked if its algorithmic review process lets Cigna doctors reject claims without examining them, the company said that description was “incorrect.” It repeatedly declined to answer further questions or provide additional details.
“This investigation impressed our judges with its originality and depth of reporting,” said Sidney judge Lindsay Beyerstein. “This story challenges the states to protect consumers from the predatory use of health insurance algorithms in place of professional judgment.”
Learn more about the story and the Sidney Award here.