The Justice Department has accused three major health insurers—Aetna, Elevance Health, and Humana—of paying illegal kickbacks to brokers to increase enrollment in their Medicare Advantage plans. These allegations involve collusion with brokers to steer beneficiaries, including those with disabilities, into plans that may not provide the best care, motivated by profit rather than patient needs. The complaint highlights discriminatory practices against disabled individuals due to their potentially high medical costs, with accusations that Aetna and Humana sought to discourage their enrollment. Filed in Boston federal court, this lawsuit marks a significant step in scrutinizing Medicare Advantage plans under the Trump administration, amid broader concerns about aggressive marketing and overcharging. Although the implicated companies deny the allegations, the case emphasizes the ongoing federal focus on ensuring that Medicare beneficiaries receive appropriate coverage without being exploited for financial gain.

Three large health insurers—Aetna, Elevance Health, and Humana—are accused of paying millions in kickbacks to brokers like eHealth, GoHealth, and SelectQuote to boost enrollments in their Medicare Advantage plans from 2016 to 2021.

Federal prosecutors allege that Aetna and Humana discriminated against disabled individuals by discouraging their enrollment in private Medicare plans due to the high costs associated with their complex health needs.

The lawsuit, initiated by a whistle-blower and joined by the Justice Department, is filed in a Boston federal court and represents the Trump administration's effort to scrutinize the Medicare Advantage program for unethical practices.

Medicare Advantage plans, criticized for aggressive marketing tactics and overbilling the government, now cover over half of Medicare enrollees, prompting increased regulatory attention and calls for reforms.

The Biden administration attempted to regulate insurer payments to brokers to curb enrollment biases, but a lawsuit has delayed the implementation of these measures, reflecting ongoing tensions over Medicare plan management.

Brokers are accused of prioritizing financial incentives over patient needs, steering clients into higher-paying plans rather than those that best meet individual healthcare requirements, facilitated by advanced technology and national brokerage networks.

U.S. Attorney Leah B. Foley emphasized the severity of targeting disabled beneficiaries for exclusion, labeling it as profit-driven malfeasance that the Justice Department is determined to address through rigorous investigation and prosecution.