The United States filed a complaint under the False Claims Act against three of the nation’s largest health insurance companies – Aetna Inc. and affiliates, Elevance Health Inc. (formerly known as Anthem), and Humana Inc. – and three large insurance broker organizations – eHealth Inc. and an affiliate, GoHealth Inc., and SelectQuote Inc. The United States alleges that from 2016 through at least 2021, the defendant insurers paid hundreds of millions of dollars in illegal kickbacks to the defendant brokers in exchange for enrollments into the insurers’ Medicare Advantage (MA) plans.
According to the complaint, the broker organizations incentivized their employees and agents to sell plans based on the insurers’ kickbacks, set up teams of insurance agents who could sell only those plans, and at times refused to sell MA plans of insurers who did not pay sufficient kickbacks. Read a story from MarketScreener and a Department of Justice press release.