Republican House Oversight Committee members announced that the committee had launched an investigation into claims of hospice fraud in California.
“Despite clear red flags, it appears California leaders have enabled hospice providers to DEFRAUD hardworking American taxpayers,” Chairman James Comer wrote on X. “The House Oversight Committee is moving to protect taxpayer funds from waste, fraud, and abuse.”
The outrage started in January when Dr. Mehmet Oz, the head of the Centers for Medicare and Medicaid Services (CMS), said California owed over $1 billion in Medicaid funds improperly used for health care for illegal aliens.
Then Leslie wrote about the hospice fraud last week, citing investigations from CBS News and Nick Shirley.
In his 40-minute video, Shirley noted that the fraud in “Minnesota was big, but California is even bigger.”
Shirley discovered that two facilities charged $6,000 per person.
Another hospice received $1.3 million. Shirley found the location empty. No employees. No equipment. No furniture.
In all, Shirley claimed he uncovered $170 million in fraud.
CBS News revealed that 700 of the 1,800 hospices in Los Angeles County “trigger multiple red flags for fraud as defined by the state.”
Oversight Republicans already discovered Gov. Gavin Newsom’s administration knew about the fraud for years:
Your administration has been aware of credible reports of hospice fraud for at least four years. According to a March 29, 2022 report from the California State Auditor, Los Angeles County, the state’s most populous county, has experienced a 1,500 percent increase in registered hospice providers since 2010.5 This increase, which totals more than 2,800 providers in the State, is more than six times the national average of hospice agencies relative to Los Angeles County’s senior population. This is greater than the number of hospice providers in 36 states combined and 33 times greater than the entire state of Florida. California’s auditors estimate that Los Angeles County hospice providers overbilled Medicare by at least $105 million in a single year. Nationwide, hospice providers bill Medicare an average of $13,200 per patient annually. Los Angeles County is billing Medicare about $29,000 per patient and has the highest concentration of hospice providers in the country with 500 located within a 3 mile radius alone. Some providers billed as much as $74,000 per patient. Eighteen Los Angeles County hospice providers all using a single doctor’s Medicare provider number reportedly billed Medicare for 76,000 claims totaling nearly $600 million between 2021 and 2024, including nearly $210 million in 2024 alone. More than 100 hospice and home healthcare agencies are registered to a single address in the Van Nuys neighborhood of Los Angeles. Recently, Centers for Medicare and Medicaid Services (CMS) Director, Mehmet Oz, estimated that Los Angeles County alone represents $3.5 billion of hospice fraud, and that 18 percent of all hospice billing in the United States comes from Los Angeles County. Last year, California Attorney General Rob Bonta called hospice fraud in California, specifically in Los Angeles County, “an epidemic.”The March 2022 audit report highlighted several red flags and key warning signs of fraud: many providers are listed at the same address; very low patient counts compared with the rest of the State; patients listed as terminally ill were later discharged alive; excessive billing for services that may not have been provided; and staff were shared across multiple hospice providers.
“Despite these red flags, it appears California has enabled hospice providers to defraud the American taxpayer and exploit vulnerable patients,” added the Republicans.
The auditor also raised the alarm that California had a 1,500% increase in hospices since 2010.
The number worried the auditor because California didn’t need more hospice agencies.
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