On May 1, 2025, the United States partially intervened in a qui tam suit against three of the nation’s largest health insurance companies — Aetna, Anthem, and Humana (collectively referred to as the Defendant Insurers) — and three insurance brokers — eHealth, GoHealth, and SelectQuote (the Defendant Brokers) — in Massachusetts federal court relating to their participation in the Medicare Advantage program. The complaint alleges that these entities violated the Anti-Kickback Statute and, in turn, the False Claims Act.
First, the complaint alleges that from 2016 through at least 2021, the Defendant Insurers paid hundreds of millions of dollars in kickbacks to the Defendant Brokers to induce them to steer Medicare Advantage beneficiaries to the Defendant Insurers’ Medicare Advantage plans. The Defendant Brokers, in turn, solicited and received these kickbacks. The complaint alleges that although these arrangements were masked as payments for “marketing,” “co-op,” or “sponsorship” services, the true intent of the payments was to incentivize the Defendant Brokers to prioritize the Defendant Insurers’ plans over those of competitors, regardless of the quality or suitability of the plans for the beneficiaries.
Second, the complaint alleges that the defendants used deceptive marketing agreements to conceal the true intent of their transactions. These “marketing” agreements were structured to appear as payments for legitimate marketing services. For example, the contracts often...
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