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DoJ Goes After Major Insurers Accused Of Medicare Advantage Fraud … from Crooks & Liars Susie Madrak

The Department of Justice accused three of the nation’s largest health insurers of paying hundreds of millions of dollars in kickbacks to brokers in exchange for steering patients into the insurers’ Medicare Advantage plans. Shocker! Via Reuters:

In a complaint, opens new tab filed in Boston federal court on Thursday, DOJ alleged that CVS Health’s Elevance Health and Humana engaged in a vast kickback scheme with insurance brokers eHealth GoHealth and SelectQuote from 2016 to 2021.

The lawsuit alleges the companies violated the False Claims Act, which prohibits submitting a false claim to the government for payment. The Justice Department is seeking unspecified damages and penalties.

CVS Health, Aetna’s parent company, and Humana in separate statements said they would defend themselves vigorously. GoHealth said the Justice Department’s case was “full of misrepresentations and inaccuracies.”

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