US accuses health insurers, brokers of Medicare Advantage kickback scheme

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Source: Reuters

BOSTON, May 1 (Reuters) - The U.S. Department of Justice accused three of the nation's largest health insurers of paying hundreds of millions of dollars in kickbacks to brokers in exchange for steering patients into the insurers' Medicare Advantage plans.

In a complaint, opens new tab filed in Boston federal court on Thursday, DOJ alleged that CVS Health's (CVS.N), opens new tab Aetna, Elevance Health (ELV.N), opens new tab and Humana (HUM.N), opens new tab engaged in a vast kickback scheme with insurance brokers eHealth(EHTH.O), opens new tab, GoHealth(GOCO.O), opens new tab and SelectQuote(SLQT.N), opens new tab from 2016 to 2021.

The lawsuit alleges the companies violated the False Claims Act, which prohibits submitting a false claim to the government for payment. The Justice Department is seeking unspecified damages and penalties.

CVS Health, Aetna's parent company, and Humana in separate statements said they would defend themselves vigorously. GoHealth said the Justice Department's case was "full of misrepresentations and inaccuracies."

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By Nate Raymond
May 1, 20254:44 PM EDT Updated 24 min ago


Read more: https://www.reuters.com/sustainability/us-files-false-claims-complaint-against-three-health-insurers-2025-05-01/

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Alternate link: https://www.yahoo.com/news/us-files-false-claims-complaint-184559921.html

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Related: The United States Files False Claims Act Complaint Against Three National Health Insurance Companies and Three Brokers Alleging Unlawful Kickbacks and Discrimination Against Disabled Americans (U.S. Department of Justice)