Editor's note: This article is sponsored by Chapter.
The U.S. government has filed a major lawsuit under the False Claims Act, targeting some of the biggest names in health insurance—Aetna, Elevance Health (formerly Anthem), and Humana—along with top insurance brokers eHealth, GoHealth, and SelectQuote. The allegation? From 2016 to at least 2021, these companies funneled hundreds of millions of dollars in illegal kickbacks to brokers to steer seniors into their Medicare Advantage plans.
If the allegations are true, it means many Americans may have been steered into Medicare Advantage plans that weren’t necessarily the best fit for their needs—not because the plans were better, but because brokers were incentivized by illegal kickbacks.
The Kickback Conspiracy
Navigating Medicare Advantage’s maze of plan options is daunting, so beneficiaries rely on brokers like eHealth, GoHealth, and SelectQuote, who claim to be unbiased guides. But from 2016 to 2021, insurers Aetna, Humana, and Elevance Health allegedly paid brokers millions in kickbacks to favor their plans, regardless of quality. Disguised as “co-op” or “marketing” deals, these payments were tied to enrollment targets. Internal emails revealed executives knew this violated the Anti-Kickback Statute, with one eHealth leader joking that the Centers for Medicare & Medicaid Services (CMS) would miss a $15 million Humana deal for minimal enrollments. Brokers used call routing to prioritize high-paying insurers, betraying beneficiaries’ trust.
Discrimination Against the Vulnerable
The scheme wasn’t just about profits—it targeted vulnerable beneficiaries. Medicare Advantage must accept all eligible enrollees, including disabled people under 65. Yet Aetna and Humana allegedly pressured brokers to limit their enrollment, as these beneficiaries were deemed to be less profitable. Brokers complied, rejecting referrals and filtering calls to favor healthier enrollees, incentivized by bonuses. This violated federal anti-discrimination laws and CMS contracts, undermining the founding principles of Medicare by discriminating against the very people it was created to aid.
False Claims and the Pursuit of Justice
The schemes led to false claims to CMS, with insurers certifying enrollments as “valid” despite kickbacks and discrimination. The government paid billions, unaware of the fraud. Examples include Humana’s $12,477 for a 2016 enrollment and Aetna’s $79,047 for a 2020 case. On May 1, 2025, the U.S. filed suit, seeking treble damages and penalties under the False Claims Act. Aetna and others deny the allegations, per May 2025 reports, promising a fierce defense. The case, demanding a jury trial, seeks justice for beneficiaries and taxpayers.
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