GoHealth’s Statement on Recent Allegations in the United States False Claims Act Complaint
May 07 2025 - 8:00AM
GoHealth, Inc. (GoHealth) (NASDAQ: GOCO), a leading health
insurance marketplace and Medicare-focused digital health company,
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
(LIS) 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.
Forward Looking Statements
This press release contains forward-looking statements within
the meaning of Section 27A of the Securities Act of 1933, as
amended (the “Securities Act”), and Section 21E of the Securities
Exchange Act of 1934, as amended (the “Exchange Act”). These
forward-looking statements are made in reliance upon the safe
harbor provision of the Private Securities Litigation Reform Act of
1995. All statements other than statements of historical facts
contained in this earnings presentation may be forward-looking
statements. Statements regarding our future results of operations
and financial position, business strategy and plans and objectives
of management for future operations and strategies are
forward-looking statements.In some cases, you can identify
forward-looking statements by terms such as “may,” “will,”
“should,” “aims,” “expects,” “plans,” “anticipates,” “could,”
“intends,” “targets,” “projects,” “contemplates,” “believes,”
“estimates,” “predicts,” “potential,” “likely,” “future” or
“continue” or the negative of these terms or other similar
expressions. The forward-looking statements in this press
release are only predictions, projections and other statements
about future events that are based on current expectations and
assumptions. Accordingly, we caution you that any such
forward-looking statements are not guarantees of future performance
and are subject to risks, assumptions and uncertainties that are
difficult to predict. Although we believe that the expectations
reflected in these forward-looking statements are reasonable as of
the date made, actual results may prove to be materially different
from the results expressed or implied by the forward-looking
statements. These forward-looking statements speak only as of the
date of this press release and are subject to a number of important
factors that could cause actual results to differ materially from
those in the forward-looking statements, including the factors
described in the sections titled “Summary Risk Factors,” “Risk
Factors” and “Management’s Discussion and Analysis of Financial
Condition and Results of Operations” in our Annual Report on Form
10-K for the fiscal year ended December 31, 2024 (“2024 Annual
Report on Form 10-K”), our forthcoming Quarterly Report on Form
10-Q for the fiscal quarter ended March 31, 2025 (“Q1 2025
Quarterly Report on Form 10-Q”) and in our other filings with the
Securities and Exchange Commission. You should read this press
release completely and with the understanding that our actual
future results may be materially different from what we expect. We
qualify all of our forward-looking statements by these cautionary
statements. Except as required by applicable law, we do not plan to
publicly update or revise any forward-looking statements contained
herein, whether as a result of any new information, future events,
changed circumstances or otherwise.
About GoHealth, Inc.
GoHealth is a leading health insurance marketplace and
Medicare-focused digital health company whose purpose is to
compassionately ensure consumers’ peace of mind when making
healthcare decisions so they can focus on living life. For many of
these consumers, enrolling in a health insurance plan is confusing
and difficult, and seemingly small differences between health plans
may lead to significant out-of-pocket costs or lack of access to
critical providers and medicines. GoHealth’s proprietary technology
platform leverages modern machine-learning algorithms, powered by
over two decades of insurance purchasing behavior, to reimagine the
process of matching a health plan to a consumer’s specific needs.
Its unbiased, technology-driven marketplace coupled with highly
skilled licensed agents has facilitated the enrollment of millions
of consumers in Medicare plans since GoHealth’s inception. For more
information, visit https://www.gohealth.com.
Investor RelationsJohn
Shavejshave@gohealth.com
Media RelationsPressinquiries@gohealth.com
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