Humana

DOJ Sues Aetna, Humana, Elevance for Paying Illegal Medicare Advantage Kickbacks and Discriminating Against Disabled Beneficiaries

| Importance: 9/10

On May 1, 2025, the Department of Justice filed a False Claims Act lawsuit against three of the nation’s largest health insurance companies—Aetna (CVS Health), Humana, and Elevance Health (formerly Anthem)—along with three major insurance brokers—eHealth, GoHealth, and SelectQuote. The …

Department of Justice Aetna CVS Health Humana Elevance Health +4 more healthcare medicare-advantage insurance-fraud systematic-corruption whistleblower +1 more
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Humana Pays $90 Million to Settle First-of-Its-Kind Medicare Part D Fraud Case for Fraudulent Bidding

| Importance: 8/10

On August 16, 2024, Humana agreed to pay $90 million to settle the first whistleblower lawsuit alleging systematic fraud in Medicare Part D prescription drug program bidding. The case exposed how Humana maintained “two sets of books”—submitting false financial projections to the Centers …

Humana Centers for Medicare & Medicaid Services Department of Justice Steven Scott (whistleblower) healthcare medicare-advantage insurance-fraud systematic-corruption whistleblower
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Questcor Raises Acthar Gel Price from $1,600 to $23,000 Overnight - Eventually Reaching 97,000% Increase Through Bribery Scheme

| Importance: 9/10

Questcor Pharmaceuticals implemented an overnight price increase for H.P. Acthar Gel from $1,600 to $23,000 per vial on August 27, 2007, launching a decade-long price gouging scheme that would eventually raise the drug’s price by 97,000% from its 2001 level. Questcor had acquired Acthar—a …

Questcor Pharmaceuticals Mallinckrodt Federal Trade Commission Humana Congress +1 more pharmaceutical-industry drug-pricing healthcare corporate-fraud bribery +2 more
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