💥 Medicare Kickbacks, SEC's Marketing Curveball & Telehealth's Legal Meltdown | Marketing’s Most Wanted

Hi Marketing Wranglers,

This week, we're diving into a $500M+ scandal that’s about to reshape how insurers and brokers market to seniors, a surprise regulatory gift from the SEC that’s rewriting the rules for investment performance promos, and a brutal legal crackdown on telehealth platforms pushing GLP-1 weight loss drugs. If you thought marketing compliance was just a checkbox exercise, this week’s headlines should change your mind.

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🚨 In This Week’s Issue

🏥 #500M+ Kickback Scheme Rocks Healthcare Giants: Aetna, Humana, and Elevance accused of turning senior care into a sales funnel.

📊 SEC Loosens the Grip: Investment advisers get clarity—and freedom—on gross-only performance metrics

⚖️ Telehealth in Trouble: Eli Lilly sues startups over "compounded" weight loss meds and deceptive marketing

🏥 $500M+ Kickback Scheme Rocks Healthcare Giants

Three of the largest players in U.S. healthcare—Aetna, Humana, and Elevance Health (formerly Anthem)—are now facing federal prosecution over what officials are calling one of the biggest Medicare fraud schemes in recent history.

The Department of Justice alleges that, from 2016 to 2021, these companies paid hundreds of millions in unlawful incentives to brokers and marketing partners to steer Medicare Advantage enrollments—violating federal kickback laws and exploiting taxpayer-funded programs for corporate gain.

The Alleged Scheme

According to cou

rt documents, the companies disguised excessive broker payments as legitimate “marketing fees” or “administrative support,” incentivizing agents to push their most profitable plans—not necessarily the best ones for patients. The alleged tactics include:

• Structuring hidden commissions to drive enrollments

• Targeting healthy seniors to maximize profit margins

• Avoiding or discouraging signups from higher-cost, disabled individuals

• Creating internal teams trained to present as “independent” advisors while pushing only one carrier's plans

In one example, prosecutors say GoHealth accepted $750,000 for what was labeled as “lead generation”—but internally documented as 3,000 guaranteed enrollments.

The Evidence

Federal authorities released internal communications and documents that revealed deliberate attempts to mask the true nature of the payments.

Emails and internal slide decks referenced terms like “bonuses,” “rewards,” and “kickers” as euphemisms for illegal broker compensation.

Implications for Using Referral or Affiliate Models

While this case centers on Medicare Advantage, its implications go far beyond healthcare. The DOJ is sending a clear signal: incentive structures must be transparent and compliant. This is a warning for any business using referral, affiliate, or broker-based marketing, especially in regulated sectors like:

• Fintech (loan and credit brokers)

• Insurance (life, auto, health, and more)

• Real estate (agents and mortgage brokers)

• Financial services (investment and wealth advisors)

Opaque “non-commission” compensation models are now high-risk, especially when they influence consumer decisions in regulated markets.

What Comes Next

Under the False Claims Act, each violation can result in penalties of up to $27,894. With years of alleged misconduct and thousands of questionable transactions, the financial exposure for the companies involved could be immense—potentially in the hundreds of millions.

But the reputational cost may be even greater. Over 33 million Americans rely on Medicare Advantage. Any breach of trust in this space has enormous consequences for public perception and long-term industry credibility.

The defendants, including CVS (Aetna), GoHealth, eHealth, and SelectQuote, deny wrongdoing. However, if the DOJ’s claims hold up, the outcomes could include:

• Tighter regulation of broker compensation and marketing programs

• Stricter enforcement of truth-in-advertising standards

• Industry-wide reforms to ensure independent advice is truly independent

• Greater DOJ focus on marketing practices in other regulated sectors

What does this mean for marketers?

For marketing, compliance, and legal teams: now is the time to review incentive structures. If referral partners, brokers, or affiliates are being paid in a way that could influence advice or steer consumers—especially in regulated industries—full transparency and documentation are essential.

The government’s message is clear: aggressive marketing is fine. Hidden payments that cross legal boundaries are not.

More on this story is covered on Insurance Newsnet.

📊 SEC Loosens the Grip: Investment Advisers Just Got Their Freedom Back

After four years of confusion and red tape, the SEC just made it dramatically easier for investment advisers to market performance metrics. No press release. No fanfare. Just a quiet update in an FAQ posted on March 19, 2025.

But the implications? Huge.

For the first time since the 2021 Marketing Rule took effect, financial firms have a green light to show gross-only and extracted performance—without running a gauntlet of net-fee disclosures and disclaimers.

Why This Matters

Until now, showcasing standout metrics (like how a single stock pick or sector strategy outperformed) often got shut down by compliance. The reason? Everything had to include net-of-fee data—even when that didn’t make sense or diluted the message.

The result was marketing that was technically correct, but unreadable. That’s over.

What You Can Do Now

The SEC is now allowing you to highlight:

• ✅ Single security performance (gross-only, no fee deduction required)

• ✅ Sector returns & volatility metrics

• ✅ Custom time periods (no more mandatory 1-, 5-, 10-year comparisons)

• ✅ Representative account data, if you include the full composite

But Here’s the Catch:

This new flexibility comes with conditions. You must:

• Clearly label anything that’s gross-only

• Include total portfolio performance (gross and net) for the same time period

• Keep comparisons consistent and understandable

• Match time periods across all metrics

What’s Still Off Limits?

Some numbers still require full net-of-fee disclosure. These include:

• Total Return

• Time-Weighted Return

• IRR

• MOIC

• TVPI

What This Means in Practice

Instead of this:

You can now say:

It’s a small change that makes a huge difference in clarity, storytelling, and investor engagement.

Action Items for Investment Firms

To take advantage of the new rules—without triggering risk—firms should act fast:

1. Audit your current marketing materials for outdated disclosures

2. Update your ad review and sign-off workflows

3. Train marketing and compliance teams on the new guidelines

4. Revise your internal marketing and compliance policies

5. Document everything to prepare for future audits or enforcement actions

Why Move Now?

This isn’t just regulatory relief—it’s a chance to differentiate. While your competitors are still burying top-performing metrics under layers of fine print, you can tell cleaner, more compelling stories—with full compliance confidence.

The compliance bottleneck just cleared. Now it’s a race to tell your best story first.

Check out K&L Gates for more information.

⚖️ Eli Lilly Cracks Down: Telehealth Sued Over Weight Loss Drugs

Eli Lilly just dropped the hammer on the booming telehealth weight loss industry. The pharmaceutical giant has launched a fresh wave of lawsuits targeting Mochi Health, Fella Health, Delilah, Willow Health Services, and Henry Meds for allegedly selling knockoff versions of its blockbuster drugs Zepbound and Mounjaro.

The accusation? These telehealth companies are exploiting legal loopholes to keep selling "compounded" versions of tirzepatide—even though the official drug shortage that justified the sale is over and the FDA has said it's time to stop.

How the "Compounded" Loophole Worked

During drug shortages, pharmacies and telehealth providers found a clever workaround: create "compounded" versions of popular GLP-1 weight loss drugs.

The legal justification? These weren't mass-produced knockoffs—they were "personalized medicine" tailored to individual patients.

But Eli Lilly isn't buying it. The company claims these platforms are mass-producing identical formulations while hiding behind the "personalized" label.

Translation: It's the same drug, just without the safety testing, FDA approval, or billion-dollar development costs.

Now that tirzepatide is back in stock, the FDA has set clear deadlines for ending compounded production.

The telehealth companies' response? Many are doubling down, saying they'll keep dispensing under "custom treatment plans."

The Marketing Battle Behind the Legal War

This isn't just about patents—it's about narrative control. Eli Lilly and Novo Nordisk (maker of Ozempic/Wegovy) are pushing hard on a "dangerous knockoffs" story, while telehealth companies counter with "affordable, personalized care" messaging.

Eli Lilly's specific accusations include:

• Deceptive marketing of untested drug versions

• False "personalization" claims for mass-produced compounds

• Encouraging cosmetic use for weight loss

• Undermining patient safety standards

Meanwhile, telehealth platforms continue running influencer campaigns, success story testimonials, and "individualized care" messaging—exactly the kind of marketing language that's now landing companies in federal court.

The Bigger Industry Shakedown

This lawsuit wave isn't isolated. Eli Lilly has already sued more than two dozen wellness clinics, medical spas, and compounding pharmacies. Novo Nordisk is fighting nearly identical battles. The FDA has set April and May deadlines for ending all compounded semaglutide production.

What's really at stake? A multi-billion dollar market where telehealth companies have been offering weight loss injections at a fraction of brand-name prices.

For anyone in healthtech, wellness, or telehealth, this legal battle is sending a clear message: your marketing language is now a liability.

High-risk terms when promoting compounded medications:

• "Personalized" or "custom" (when products are mass-produced)

• "Safe" or "FDA-approved" (when they're not)

• Weight loss "success stories" (potentially off-label promotion)

• "Affordable alternative" (could imply therapeutic equivalence)

The bottom line: Even if you're operating in a clinical gray area, your marketing can't be. Regulators and Big Pharma are watching every campaign, every influencer post, and every patient testimonial for compliance violations.

The weight loss telehealth boom created a billion-dollar industry practically overnight. Now the legal reckoning is here—and it's being fought as much in on landing pages as it is in courtrooms.

Read more on PT News.

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→ Join the community here.