On May 1, 2025, the Department of Justice filed a complaint in intervention in a qui tam case that Gregg Shapiro filed in 2021 on behalf of a whistleblower client against several of the nation’s largest Medicare Advantage insurance carriers and brokers. A copy of the government’s complaint is here, and a copy of the whistleblower’s amended complaint is here. A link to the Department of Justice press release is here.
The whistleblower alleged that the carriers paid kickbacks to induce the brokers to steer Medicare beneficiaries to the carriers’ Medicare Advantage plans. He further alleged that two of the carriers, Aetna and Humana, pressured the brokers to discriminate against Medicare beneficiaries with disabilities.
The United States intervened against three carriers – Aetna, Humana, Anthem – and three brokers – GoHealth, SelectQuote, and eHealth. The whistleblower’s amended complaint also names a fourth carrier – Wellcare. The United States previously filed a notice that is not intervening at this time against Wellcare.