BRYAN, Texas (KBTX) – Fraudulent hospice operators are billing Medicare for millions of taxpayer dollars in Texas, and some are enrolling patients who don’t even know they’re on service, according to testimony presented to state lawmakers.
Lisa McNair, president and CEO of Hospice Brazos Valley, testified before the Texas Senate Committee on Health and Human Services in April with research showing the number of hospices in Texas has nearly doubled since 2020. There are now more than 1,300 hospices operating in the state.
Investigators and advocates say some are billing Medicare for patients who were never appropriate for hospice or who don’t even know they’re enrolled.
McNair told KBTX that the fraud is draining taxpayer dollars and eroding trust in legitimate end-of-life care.
How the fraud works
McNair’s research found as many as 15 hospices operating out of a single building, all under the same owner.
“The reason you do that is you go under the radar screen. You’re new and able to operate with a very small census, therefore, you don’t have to report quality data,” McNair said.
She said just 10 patients per hospice generates $60,000 a month in Medicare billing.
“Take 10 patients, multiply that times 15 hospices working under one building, under one owner, and you can do the math. That’s many millions of dollars that’s being frauded from the government,” McNair said.
McNair said some hospices are enrolling patients who have no idea they’re even on service, then billing Medicare in their name.
Lisa McNair, the President and CEO of Hospice Brazos Valley, exposed hospice fraud across Texas to state lawmakers.(kbtx)
“Patients are on service, they don’t even know that they’ve been brought on hospice. They’re going to seek treatment, and when they get there, they’re like, ‘you’re on hospice,’” McNair said.
She said it’s happening at least once a week in Brazos County. Families who specifically request Hospice Brazos Valley are being approached by competing hospices and signed without realizing it.
“We have examples all the time of people that come and go, we asked for you, and before we knew it, someone else had come in. We thought they were you, but then we signed papers and realized we were with a different hospice,” McNair said.
Red flags and what’s next
McNair said some hospices have 100% live discharge rates, meaning every patient brought onto service is discharged alive.
“You don’t normally come on hospice to live. You come on hospice because you’re at the end of your life. When you have a live discharge rate of 100%, that means every patient that you’ve brought on service, you’re discharging them alive. Why would you do that? Why does that look suspicious? It’s because you’re bringing them on, you’re billing for services. They were never appropriate for hospice,” McNair said.
According to her research, 61% of Medicare-certified hospices in Texas did not report any quality data in 2025.
According to Lia McNair, Texas lawmakers and regulators are taking a closer look at hospice facilities in Texas.(kbtx)
McNair is calling on Texas lawmakers to stop issuing new hospice licenses while the state investigates the ones already operating.
“Let’s look at the licenses we’ve issued, who’s appropriate, who’s not appropriate. Let’s back that up a little bit. Then, lift the moratorium when you’re confident that you have a handle on how licenses are being issued in the state of Texas,” McNair said.
McNair said the state is already drafting new rules, and federal regulators are now taking a closer look at Texas.
What families should know
According to McNair, Hospice Brazos Valley is the only nonprofit hospice provider in a 17-county area and is currently ranked number one in the state for quality.
If your family is choosing a hospice, check the star rating on Hospice Compare, a free federal website.
If someone shows up at your door, ask for identification and confirm which hospice they represent before you sign anything.
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