DOJ Files Complaint Against Aetna, eHealth, Others, Alleging Medicare Advantage Kickbacks

Dow Jones
05-02
 

By Katherine Hamilton

 

The Justice Department filed a complaint alleging three of the largest health insurers paid illegal kickbacks to three of the biggest health-insurance brokers.

The DOJ alleges in its complaint that CVS Health-unit Aetna, Elevance Health and Humana paid the kickbacks to brokers eHealth, GoHealth and SelectQuote in exchange for enrollments into the insurers' Medicare Advantage plans. The complaint, filed Thursday, said the alleged transactions occurred from 2016 to 2021.

Patients often work with insurance brokers to choose a provider. Beneficiaries of the Medicare Advantage program can enroll in plans offered by private insurers.

The DOJ alleges the brokers included in the complaint didn't act as unbiased stewards to help consumers choose a provider, but rather directed them to insurers that paid the most in kickbacks.

The department also alleges Aetna and Humana pressured brokers to enroll fewer Medicare beneficiaries with disabilities by threatening to withhold kickbacks.

 

Write to Katherine Hamilton at katherine.hamilton@wsj.com

 

(END) Dow Jones Newswires

May 01, 2025 14:46 ET (18:46 GMT)

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