Hospice fraud in California has been remarkably brazen. Medicare recipients have been signed up for care without their knowledge by thieves who stole their identities. Providers have paid kickbacks to people to enroll even though they aren\u2019t terminally ill and don\u2019t qualify. Sham companies have fabricated lists of employees.<\/p>\n
The schemes have been an irresistible political target for President Trump, who mentioned California as a top offender when he created a task force last month to root out corruption in federally funded programs. He said that he believed that fraud in the nation\u2019s most populous state was \u201c10 times worse\u201d than anywhere else.<\/p>\n
But long before Mr. Trump weighed in, state investigators had uncovered rampant fraud in California\u2019s hospice system on their own. For years, state and federal officials had been taking steps to combat abuses, and the state has stopped issuing new hospice licenses.<\/p>\n
Despite the actions underway, Mr. Trump has made hospice fraud in California a new political flashpoint.<\/p>\n
In recent weeks, nearly every day has brought dueling announcements from Democrats and Republicans about busted Medicare abuse schemes or calls for legislative sessions to examine fraud in the state. Dr. Mehmet Oz, the former talk show host who now runs the Centers for Medicare and Medicaid Services, has been an emissary of the Trump administration\u2019s campaign against California, visiting the state and posting videos<\/a> decrying health care fraud there. On Tuesday, a House committee held a special hearing on Medicare fraud with a focus on hospice abuse in California.<\/p>\n \u201cOpen-border states led by Democrats like Minnesota, New York and California are the epicenters of fraud in this country,\u201d Representative Jason Smith, a Missouri Republican who chairs the Ways and Means Committee, said at the hearing. California in particular, he said, had \u201copened the door for millions to be stolen.\u201d<\/p>\n The feud comes months after Mr. Trump seized on conservative furor over welfare fraud in Minnesota, another Democrat-led state, and blamed Gov. Tim Walz for the problem. Though Mr. Walz insisted that he was cracking down, the political fallout was severe enough that he decided not to run for re-election.<\/p>\n In California, Republicans have tried to pin the hospice problem on another prominent Democrat, Gov. Gavin Newsom, who is widely considered to be a 2028 presidential contender. The simmering outrage against both states has been stoked by Nick Shirley, a conservative content creator. Mr. Shirley posted a video in March in which he visited registered hospices in California that didn\u2019t seem to exist.<\/p>\n No one disputes that hospice fraud in California is a problem, but federal and state leaders blame each other for the scale of it. The federal government administers Medicare, which certifies hospice facilities and funds most hospice care, while the state issues the initial licenses for hospices to operate.<\/p>\n Even as hospice fraud becomes increasingly politicized, advocates and lawmakers in California who have long pushed for a crackdown on abuses say they welcome the new focus. A 2022 state audit<\/a> found that a lack of oversight had allowed hospices to be licensed with almost no vetting, to overbill Medicare by millions each year and to put patients at risk of receiving dangerously substandard care.<\/p>\n \u201cHopefully, now there\u2019s a new urgency around this, because these are extremely vulnerable patients, they\u2019re vulnerable families,\u201d said Jacqui Irwin, a Democrat in the State Assembly who has sponsored multiple bills to clamp down on hospice fraud. \u201cFor a lot of hospices, their main goal is just to defraud Medicare.\u201d<\/p>\n Hospice provides palliative care and other medical services for people who have six months or less to live. But there have been numerous reports of Californians being enrolled in hospice without their knowledge and providers billing millions in fraudulent claims.<\/p>\n In one scheme, a couple said they were promised $300 per month to sign up for hospice care they didn\u2019t need.<\/p>\n In another recent case investigated by the state, fraudsters in Southern California purchased personal information off the dark web and began billing for purported services to people whose identities had been stolen. No hospice services were ever rendered, and there were no actual hospice centers or any paperwork, but the state was defrauded of $267 million.<\/p>\n Lynn Ianni, 69, found out she had been enrolled in hospice when she was seeking physical therapy for a shoulder injury from playing pickleball. Ms. Ianni, a clinical psychotherapist, was not dying, but was told she couldn\u2019t gain access to her normal Medicare benefits because she was in hospice.<\/p>\n It took months for her to correct the problem and regain access to her Medicare benefits, Ms. Ianni testified to the House committee on Tuesday. She said she discovered that the sham hospice company had stolen the name of a surgeon for billing purposes.<\/p>\n \u201cImagine being told in effect that you\u2019re at the end of your life when you\u2019re not, and then being denied access to care because of that error,\u201d she said. \u201cIt was not just frustrating. It was terrifying.\u201d<\/p>\n