AssuredPartners Inc. and its former Florida subsidiary, AP of South Florida LLC (APSF), have agreed to pay more than $135 million to resolve False Claims Act allegations arising from a fraudulent scheme to exploit federal Affordable Care Act subsidy programs. The settlement, reached with the U.S. Department of Justice Civil Division and the U.S. Attorney’s Office for the Middle District of Florida, with investigative support from HHS-OIG, resolves civil allegations that APSF executives systematically enrolled homeless and low-income individuals in fully subsidized ACA marketplace plans for which those individuals were ineligible — generating approximately $141.5 million in federal premium subsidies the companies were not entitled to receive. APSF separately faced a parallel criminal matter resulting in $27.6 million in criminal restitution.
The case originated with a qui tam complaint filed under seal by an anonymous relator — a whistleblower whose identity has not been publicly disclosed. Here, the anonymous whistleblower’s share amounted to $24.3 million, representing a substantial portion of the civil recovery. This award reflects the significance of the inside information the relator provided to federal investigators.
The APSF scheme illustrates a category of ACA fraud that federal enforcement agencies have increasingly prioritized: the deliberate targeting of vulnerable populations — in this case, homeless individuals — as vehicles for capturing government subsidies rather than providing genuine coverage. Because ACA premium tax credits flow directly from federal coffers, schemes of this kind impose costs on taxpayers and distort the insurance markets the ACA was designed to stabilize.