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Update: DOJ Sues Medicare Insurers Over Alleged Kickback Scheme
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Update: DOJ Sues Medicare Insurers Over Alleged Kickback Scheme
May 26, 2025 12:37 AM

03:12 PM EDT, 05/02/2025 (MT Newswires) -- (Updates with responses from CVS Health ( CVS ), Humana, Elevance Health ( ELV ) and GoHealth ( GOCO ) in the third, fourth, fifth and sixth paragraphs.)

The US Department of Justice on Thursday filed a complaint in federal court alleging that three of the country's largest health insurance companies offering Medicare Advantage plans paid "hundreds of millions of dollars in kickbacks" to insurance brokers from 2016 through at least 2021 to steer beneficiaries toward their plans.

The DOJ named CVS Health's ( CVS ) Aetna, Elevance Health ( ELV ) and Humana (HUM) in the case, as well as brokers eHealth (EHTH), GoHealth ( GOCO ) and SelectQuote.

"Aetna designed and executed its marketing programs and compensation to brokers to comply with [Centers for Medicare & Medicaid Services] rules, and we continue to believe that we did so," a CVS spokesperson told MT Newswires via email. "We dispute the allegations and intend to defend ourselves vigorously."

A Humana spokesperson told MT Newswires that the company "strongly disagrees with the allegations in the complaint and we look forward to vigorously defending ourselves in the legal proceedings."

"We are confident that our health plans have complied with and continue to comply with the Centers for Medicare & Medicaid Services, marketing and broker compensation regulations, rules and guidelines. We intend to vigorously fight the allegations in the complaint," an Elevance spokesperson told MT Newswires via email.

GoHealth ( GOCO ) said it is aware of the United States Attorney's Office's decision to intervene in a Qui Tam lawsuit that names several defendants, including GoHealth ( GOCO ).

"We are disappointed with their decision to intervene and disagree with their accusations, which are full of misrepresentations and inaccuracies. We intend to vigorously defend against these allegations, and we will not allow this litigation to distract from our mission to provide peace of mind to the Medicare beneficiaries that we serve," a GoHealth ( GOCO ) spokesperson told MT Newswires via email.

eHealth did not immediately reply to requests for comment from MT Newswires.

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