We have been reporting on the astonishing levels of fraud in the Medicaid system, especially in hospice services.
The level of abuse in this system involving California services is mind-blowing. Vice President JD Vance’s anti-fraud task force originally suspended 70 hospice and home health care businesses in Los Angeles at the start of his efforts.
The move came shortly after investigations by CBS News and Nick Shirley revealed a fraud scheme in California involving hospices.
Then Vance’s task force suspended over 400 more.
Subsequently, House of Representatives lawmakers convened on Capitol Hill to hold a hearing on Medicare fraud. The witness testimony regarding fiscal abuse and corruption is staggering.
Sheila Clark, president and CEO of the California Hospice and Palliative Care Association, focused on what advocates call “ground zero” for hospice fraud in LA County, telling lawmakers about empty offices with mail piled up, whose owners purport to be providing hospice services.When someone is fraudulently enrolled in hospice care, it can be difficult to get unenrolled. Many victims spend hours trying to get someone to help them remove the care they do not need and were fraudulently signed up for. Hospice care enrollment also often disqualifies them from getting other medical care they do need through Medicare.Clark recommended Congress create a mechanism for people to get out of a fraudulent hospice enrollment, so they’re not left trapped in the system unable to get other care.”We need better enforcement on entry. We need better enforcement at licensure, at the state level. We need it at the certification, the accreditation agencies,” Clark said. “We’re not going to convict our way out of this. We have to stop them from entering the system.”
Clark described how one burrito stand was registered as a hospice.
You’d be amazed at how many hospices, the door you can walk up to in California and there is nobody there. There is five months worth of mail that you can see stacked up from CMS and nobody’s there. And that passed a survey. How did that happen?How do you put a hospice in a burrito stand in California? How do you put a hospice in a tire store in California? That all had to be vetted through licensure and certification and accreditation.
One longtime psychotherapist testified she was locked out of her own medical care for months because of a fraudulent enrollment already existing in her name.
Among those who testified was Dr. Lynn Ianni, who is a licensed psychotherapist with nearly 40 years of clinical experience. She told lawmakers that she was locked out of her own medical care for months after a fraudster falsely enrolled her in hospice care.Imagine being told, in effect, that you are at the end of your life when you are not and then being denied access to care because of that error. It was not just frustrating. It was terrifying,” Ianni said.
The efforts to combat this staggering amount of fraud in California is continuing. In the wake of the Centers for Medicare & Medicaid Services’ (CMS) “Fraud War Room”, Administrator Dr. Mehmet Oz recently noted he has not heard complaints from families after shutting down the 400 apparently fake facilities.
Shockingly, CMS received “zero” complaints over the “hundreds of millions” of dollars that have been cut off from those hospice programs, Oz claimed, blasting blue state policies for having weak guardrails.“[During] the last 10 weeks we have shut down, stopped paying over 400 hospices in Los Angeles, in California,” Oz exclusively revealed to The Post’s Miranda Devine. “But here’s the better part of this. Guess how many have complained to us?The TV doctor-turned CMS honcho estimated that there’s roughly $100 billion in annual fraud plaguing social services, contending that the federal government is too trusting of certain service providers.
Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. made a similar point during his time in front of the Ways and Means committee.
“We’ve already shut down 500 hospices in Los Angeles, and incidentally we haven’t had one call from Congress or anybody else about complaining because clearly these were fraudulent.A lot of these places—you’d say they would just invent addresses that would obtain patient identification, or they would pay people. They were going and giving people in poor neighborhoods flat-screen televisions—$600 bucks—and then they would enlist them and enroll them in the hospice, and we were paying them $6,000 dollars.”
If a “hospice” can operate out of a burrito stand with no staff, piles of unopened mail, and zero actual patients receiving legitimate care, then we aren’t looking at a few bad actors. The reality is that we are staring at an abyss of abuse that is curated by corrupt people in the system and the toxic political leadership that supports that system.
The sheer scale of the fraud, combined with the complete absence of complaints when hundreds of these “providers” were shut down, tells us everything we need to know. Neither burrito nor real patients were being served — taxpayer dollars were.
At some point, California regulators will have to explain how burritos, tires, and phantom offices qualified for Medicaid healthcare funding while legitimate patients are locked out of care and citizens are being squeezed for every penny in taxes as they work hard to support their families.
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