{"id":433,"date":"2025-05-23T18:45:00","date_gmt":"2025-05-23T18:45:00","guid":{"rendered":"https:\/\/commandcancel.com\/?p=433"},"modified":"2025-06-09T10:48:54","modified_gmt":"2025-06-09T10:48:54","slug":"trumps-doj-accuses-medicare-advantage-insurers-of-paying-kickbacks-to-brokers","status":"publish","type":"post","link":"https:\/\/commandcancel.com\/index.php\/2025\/05\/23\/trumps-doj-accuses-medicare-advantage-insurers-of-paying-kickbacks-to-brokers\/","title":{"rendered":"Trump\u2019s DOJ Accuses Medicare Advantage Insurers of Paying \u2018Kickbacks\u2019 to Brokers"},"content":{"rendered":"

A blockbuster lawsuit<\/a> from the federal Department of Justice alleges that insurers Aetna, Elevance Health (formerly Anthem), and Humana paid \u201chundreds of millions of dollars in kickbacks\u201d to large insurance brokerages eHealth, GoHealth, and SelectQuote. The payments, made from 2016 to at least 2021, were incentives to steer patients into the insurer\u2019s Medicare Advantage plans, the lawsuit alleges, while discouraging enrollment of potentially more costly disabled beneficiaries.\u00a0<\/p>\n

All the insurers and brokers named in the case have denied the allegations and say they will fight them in court.\u00a0<\/p>\n

Policy experts say the lawsuit, filed May 1, will add fuel to long-running concerns<\/a> about whether Medicare enrollees are being encouraged to select the coverage that is best for them \u2014 or the one that makes the most money for the broker.\u00a0\u00a0<\/p>\n

In other Medicare news, The Wall Street Journal<\/a> last week, citing unnamed sources, reported that a separate insurer, UnitedHealth Group, was being investigated by the Justice Department regarding unspecified potential Medicare violations. UnitedHealth pushed back, calling the article \u201cdeeply irresponsible\u201d<\/a> and saying it had not been notified by the DOJ as to any such investigation.\u00a0<\/p>\n

Regardless of how this attention shakes out, Medicare Advantage, the private sector alternative to original Medicare, is likely to continue to draw scrutiny because it covers more than half of those enrolled. But the plans, which often include benefits not covered<\/a> by the traditional government program, cost taxpayers more<\/a> per enrollee and have drawn criticism for requiring patients to get prior authorization<\/a> for certain services, something rarely required in original Medicare.\u00a0<\/p>\n

The DOJ lawsuit alleges insurers made large payments they called \u201cmarketing\u201d or \u201csponsorship\u201d fees to get around rules that set caps on broker commissions. The payments, according to the lawsuit, added incentives \u2014 often more than $200 per enrollee \u2014 for brokers to direct Medicare beneficiaries toward their coverage \u201cregardless of the quality or suitability of the insurers\u2019 plans.\u201d\u00a0<\/p>\n

The case joins the DOJ in a previously filed whistleblower lawsuit brought by a then-employee of eHealth, Andrew Shea. The whistleblower\u2019s attorney, Gregg Shapiro, said his client is grateful the DOJ chose to intervene: \u201cPeople with Medicare must know that when an insurance agent recommends a plan, that recommendation is based solely on the client\u2019s individual needs and preferences,\u201d Shapiro said in an emailed statement.\u00a0<\/p>\n

While encouraged that the Trump administration filed the case under investigations initiated by the Biden administration, policy experts say Congress and insurers need to do more.\u00a0<\/p>\n

\u201cWhat we see in this lawsuit highlights the terrible incentives that desperately need Congress to reform,\u201d said Brian Connell, a vice president at the Leukemia & Lymphoma Society, an advocacy group.\u00a0<\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>\n","protected":false},"excerpt":{"rendered":"

A blockbuster lawsuit from the federal Department of Justice alleges that insurers Aetna, Elevance Health…<\/p>\n","protected":false},"author":1,"featured_media":286,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[14],"tags":[],"_links":{"self":[{"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/posts\/433"}],"collection":[{"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/comments?post=433"}],"version-history":[{"count":1,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/posts\/433\/revisions"}],"predecessor-version":[{"id":434,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/posts\/433\/revisions\/434"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/media\/286"}],"wp:attachment":[{"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/media?parent=433"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/categories?post=433"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/commandcancel.com\/index.php\/wp-json\/wp\/v2\/tags?post=433"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}