GoHealth ‘firmly denies’ allegations made by the Government

The company said, “GoHealth (GOCO) firmly denies the allegations made by the Government in a lawsuit in which the company has been named as a defendant related to events that allegedly occurred between 2016 and 2021. We are disappointed that the Government is pursuing claims against a company that has at all times worked to advance the interests of the Medicare Advantage program and the Medicare beneficiaries it serves. GoHealth maintains that it complied with the laws that were specifically designed by Congress and HHS to address payments by Medicare Advantage carriers to the brokers that sell their plans. GoHealth denies that it received kickbacks, and similarly, it denies that it placed beneficiaries in suboptimal plans due to compensation from carriers or that it engaged in any form of discrimination. GoHealth has a history of being a leader in enrolling special needs beneficiaries. Over the last five years, the special needs population represented 17% of the Medicare Advantage population, whereas it represented 35% of GoHealth enrollees. In addition, through the years, GoHealth has differentiated itself in the industry by implementing programs designed to prioritize the beneficiaries’ needs. For example, GoHealth’s Low Income Subsidy team focused on determining eligibility of beneficiaries for special government programs, such as the Medicare Savings Program and Medicare Part D Extra Help Program, helping eligible beneficiaries to enroll in those programs at no charge and with no financial benefit to GoHealth. GoHealth’s PlanFit program incentivizes our agents to conduct a proper plan review even when the agents determine and recommend beneficiaries stay in their current plan. GoHealth strives to lead the way in our industry to ensure Medicare beneficiaries are well served. We share our Government’s goal of ensuring the Medicare industry provides the best possible healthcare for eligible American citizens. GoHealth intends to vigorously defend itself and we will not be distracted from our purpose and mission to provide our customers with peace of mind in their healthcare decisions so they can focus on living their lives.”