SoCal Fraudulent Hospices News

[SVPete]

This looks to be growing legs, so I lifted this article from the 4/4 daily thread:

FBI Busts $7.4 Million Hospice Fraud Scheme in Calif.

https://www.newsmax.com/us/fbi-hospice-fraud/2026/04/03/id/1251754/

The FBI arrested a married couple accused of fraudulently billing Medicare for $7.45 million while running a hospice with a survival rate reported to be more than 97% after five years, in what federal officials say is part of a broader crackdown on rampant healthcare fraud.

The early-morning Thursday raid in San Dimas, California, targeted Gladwin and Amelou Gill, who co-owned 626 Hospice, operating as St. Francis Palliative Care.

Authorities said the unusually high survival rate at the hospice — a major red flag given hospice patients are typically terminally ill — helped trigger the investigation.

A 97% "survival rate" is a massive red flag, and that it was over a 5 year period, yeah, fraud. A real hospice has very few patients, annually, who are discharged for no longer qualifying for hospice care.

[SVPete]

The most connected hospice doctor in California

https://www.cbsnews.com/projects/2026/hospice-fraud-dr-bhuva/

A CBS News Investigation found one Los Angeles County hospice physician's name, Dr. Rajiv Bhuva, on Medicare claims for nearly 2,800 patients across 126 California hospices in 2024, according to the last full year of available data.

A real hospice medical director oversees just 100-200 patients at any given time, and one hospice is pretty much a full-time job. Being "medical director" for 126 hospices and having almost 2800 patients in the span of a year is grossly obvious fraud.

[SVPete]

This March 2026 CBS News article gives more background:

We visited “ground zero” for hospice fraud: Los Angeles, California

https://www.cbsnews.com/projects/2026/hospice-fraud/

At age 69, Lynn Ianni is a pickleball whiz, zipping from dinks to drives energetically. When she suffered an injury on the court two years ago, she sought physical therapy, and was surprised to learn her Medicare insurance wouldn’t cover it.

She was, according to Medicare records, dying and in hospice.

“They said, ‘you're in hospice.’ And I said, ‘what? What are you talking about?” Ianni said. “‘Are you kidding me? Do I look like I’m in hospice?’”

Ianni’s Medicare number had been stolen, and used by a company to fraudulently enroll her in hospice – specialized, compassionate care for terminal patients nearing the end of their lives. It was another example of fraud in the hospice industry, long a nationwide problem. But her case arose well after officials had promised to stamp it out in California, where the problem has been especially acute.

Medicare is federally administered, and hospices must be certified for reimbursements. But the state issues the licenses for hospices to operate.

Three years ago, California’s state auditor sounded the alarm that Los Angeles County had seen a 1,500% increase in hospice companies since 2010 – more than six times the national average relative to its elderly population.

Auditors estimated LA County hospices overbilled Medicare by $105 million in a single year. The report called out notable red flags – key warning signs of fraud:

* Multiple hospices in one building

* Geographic clustering

* Low patient counts

* High rates of terminally ill patients later discharged alive

* Excessive billing

* Staff shared across multiple companies

The state auditor flagged this three years ago. The State of California basically did a token CYA-grade response.

[SVPete]

Also from March 2026:

State records show 89 hospice companies at one Los Angeles office plaza. We went to look for ourselves.

https://www.cbsnews.com/news/hospice-fraud-investigation-los-angeles-office-plaza/?intcid=CNM-00-10abd1h

The Merabi Professional Medical Plaza, a three-story, 32,000 square foot stucco and glass office building in Los Angeles, is home to a salon, a law office, a modeling agency, a realty corporation and, also, 89 licensed hospice companies.

Patient advocate Sheila Clark, who has worked to expose allegations of widespread Medicare fraud in the hospice industry, calls this building "ground zero" for the issue.

"This particular building I noticed, I'm like, 'dang, how can there be that many licensed and certified hospices in this tiny little building?,'" Clark said.

The building is among the most extreme cases of what's known as "clustering" to turn up in a sweeping CBS News investigation — a grouping of large numbers of hospice offices that state auditors consider a major red flag for potential fraud.

The immediate issue/vulnerability is the split oversight. Medicare oversee claims payments, but the State of California certifies hospice organizations. The certification process should flag multiple hospices at the same address. Hospices that do not have their own care facility are not unusual, but their administrative offices will not be tiny. 89 hospice organizations registered to a mere 32,00 square-foot office building is grossly obvious fraud. 4 or 5 in that space would be odd but plausible, but not 89.

The multiple clusters in a fairly small geographic area suggests a fairly large, probably networked, degree of organization. The sloppy certification process and token response to the evidence of massive fraud suggest that some bureaucrats may be colluding with the fraudsters.

I expect AG Rob Bonta will be worthless at best, and may actually try to impede Federal anti-fraud efforts ... because Trump.

I've not seen reports of an ethnic pattern in this, I would not be surprised if there is, and if Race Cards start flying.