U.S. Prosecutors Accuse Large Insurers of Paying Kickbacks for Private Medicare Plans – The New York Times

The Justice Department accused three of the nation's largest health insurance companies of paying illegal kickbacks in hundreds of millions of dollars over several years to insurance brokers who led people to private Medicare plans.

Federal prosecutors also accused the two insurers of conspired with brokers to discriminate against people with disabilities by blocking enrollment in private Medicare plans because they believed the insurers would be more expensive.

Approximately 12% of Medicare beneficiaries are under the age of 65 and are disabled and are eligible for the federal insurance program. Given their complex health needs, their care can be expensive.

According to ComplaintOriginally brought by whistleblowers, the Department of Justice, the country's largest health insurance company, has been joined by the Department of Justice. Previously known as Anthem. And Humana – has been accused of paying kickbacks to three large brokers, Ehealth, GoHealth and SelectQuote, to increase enrollment in the Medicare Advantage plan. These brokerage companies are also responsible for fraud.

Complaintfiled in federal court in Boston, claiming that the kickback occurred from at least 2016 to 2021, accusing Aetna and Humana of discriminating against people with disabilities.

Aetna, Elevance, Gohealth and Humana denied the allegations, but others did not immediately respond to requests for comment.