U.S. Prosecutors Accuse Large Insurers of Paying Kickbacks for Private Medicare Plans (Reuters)

The U.S. Department of Justice has filed a False Claims Act lawsuit in Boston federal court accusing three of the country’s largest insurers—CVS Health/Aetna, Elevance Health and Humana—of running a massive kickback scheme between 2016 and 2021. According to the complaint, the insurers paid hundreds of millions of dollars in “marketing,” “co-op” or “sponsorship” fees to brokers—eHealth, GoHealth and SelectQuote—in exchange for steering Medicare beneficiaries into the insurers’ Medicare Advantage plans. The DOJ alleges that brokers prioritized plans offering the highest kickbacks (and even avoided enrolling less-profitable patients, such as those with disabilities) rather than acting in their clients’ best interests.