The US government has sued Aetna, Humana, and CVS Health over allegations of a massive kickback scheme involving insurance brokers and Medicare Advantage plans. The Justice Department claims that the three health insurers paid hundreds of millions of dollars in bribes to brokers in exchange for steering patients into their plans. This allegedly led to Medicare beneficiaries being steered away from plans offered by other insurers due to their disabilities, who were deemed less profitable.
The lawsuit alleges that Aetna and Humana also threatened to withhold kickbacks if the brokers enrolled more or fewer patients with disabilities. The Justice Department is seeking unspecified damages and penalties. GoHealth has denied the allegations, stating that they are “full of misrepresentations and inaccuracies”. Elevance Health has not commented on the case.
Medicare Advantage plans are offered by private insurers who are paid a set rate to manage healthcare for older adults with extra benefits. Insurance brokers often help patients choose plans, but in this alleged scheme, they steered beneficiaries towards the most profitable plans for themselves, rather than acting in their best interests. The Justice Department is seeking to hold these companies accountable for violating the False Claims Act, which prohibits submitting false claims to the government.
Source: https://nypost.com/2025/05/01/business/aetna-humana-sued-by-feds-over-alleged-medicare-kickback-scheme