US Alleges Medicare Insurers, Brokers Used Illegal Kickbacks

The U.S. Department of Justice sued top health insurance companies and brokers alleging they used illegal kickbacks to steer members into certain private Medicare Advantage plans.

The complaint names units of CVS Health Corp., Elevance Health Inc. and Humana Inc., along with broker companies eHealth, Inc., GoHealth, Inc., and SelectQuote Inc.

The government lawsuit, which was initiated by a whistleblower in 2021 and unsealed Thursday, alleges that brokers told their agents to sell Medicare Advantage based on the kickbacks and blocked the sale of insurance plans that didn’t pay. The complaint, which covers behavior from 2016 through 2021, further alleges that Aetna and Humana pressured brokers to enroll fewer disabled people in their plans.

Medicare Advantage is a private version of Medicare, the government health plan mostly for people in the US aged 65 and older. Over half of the Medicare population are enrolled in these private plans. They often enroll in plans with the help of a broker, who may be paid commissions by insurance companies.

Congress has investigated these payments before. EHealth, GoHealth, and SelectQuote previously disclosed that they received subpoenas from the US Attorney’s Office in Massachusetts in 2022 regarding their arrangements with insurers. That office is one of several involved in the lawsuit unsealed Thursday.

“We are still reviewing the complaint, but disagree with the allegations, and intend to defend the case vigorously,” CVS spokesperson David Whitrap said.

Shares of all the insurers and broker companies fell after the news was announced.

Representatives from Elevance and Humana did not respond to requests for comment. Emails to eHealth, GoHealth, and SelectQuote were not immediately returned.