The DoJ intervened in the whistleblower lawsuit, alleging that the MA Organizations paid the broker defendants hundreds of millions of dollars in purported “marketing” funds. In reality, these payments were kickbacks tied to enrollment numbers.
On March 25, 2026, a federal district court in Massachusetts rebuffed efforts to derail a lawsuit over an elaborate scheme in which Medicare Advantage Organizations (MAOs) paid brokers millions of dollars to drive up enrollment in their Medicare Advantage (MA) plans and discriminate against disabled Medicare beneficiaries. We previously covered this lawsuit in this Health Affairs Forefront article.
The US Department of Justice (DoJ) intervened in this whistleblower lawsuit, United States ex rel. Shea v. eHealth, Inc. et al., in May 2025. The DoJ alleged that the MAOs (Aetna, Humana, and Anthem) entered into agreements with the broker defendants (eHealth, GoHealth, and SelectQuote) under which the MAOs paid hundreds of millions of dollars in purported “marketing” funds. On paper, these funds were disguised as payments for training, customer service, advertising, and similar administrative services, but, in reality, they were kickbacks tied to enrollment numbers. Further, DoJ alleged that Aetna and Humana also tied the kickbacks to brokers limiting the enrollment of Medicare beneficiaries with disabilities—so-called “U65” beneficiaries, those under 65 who qualify for Medicare through disability rather than age.
DoJ...
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