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California and federal authorities increase oversight to counter hospice fraud
Vulnerable seniors lose medical coverage after fraudulent enrollments spark state and federal enforcement measures.
The short version
- Federal and California officials are taking action against widespread hospice fraud, which has led to more than 1,000 California hospices being removed from Medicare since early 2025 and nearly 500 state licenses revoked since 2021.
- Scammers have used stolen identities and trickery to enroll healthy seniors into hospice care, causing Medicare to deny coverage for their outside medical treatments and procedures.
- The federal government established a nationwide six-month moratorium on new Medicare hospice enrollments in May, while California adopted emergency regulations in June to enforce stricter licensing rules.
- The total number of unwitting victims enrolled by fraudulent operators remains unknown, though federal officials estimate LA County alone accounts for $3.5 billion in fraudulent claims.
Key facts
- Federal officials estimate that Los Angeles County accounts for approximately $3.5 billion in fraudulent hospice claims.[Associated Press]
- More than 1,000 California hospices have been removed from Medicare since early 2025.[Associated Press]
- California has revoked nearly 500 hospice licenses since instituting a moratorium in 2021 and enacted emergency licensing regulations in June.[Associated Press]
- The Centers for Medicare and Medicaid Services implemented a six-month nationwide moratorium on new Medicare enrollments for hospice and home care providers in May.[Associated Press]
- Because Medicare does not cover outside medical treatments for individuals enrolled in end-of-life hospice care, victims of fraudulent enrollments have faced denied medical claims and delayed care.[Associated Press]
- Federal prosecutors brought charges in five LA-area hospice fraud cases in April, while California Attorney General Rob Bonta announced 21 arrests linked to a stolen-identity hospice scheme.[Associated Press]
What remains uncertain
- Advocates report that there is no precise estimate of how many seniors have been fraudulently enrolled in hospice care without their knowledge.[Associated Press]
- California state officials state that the federal government has deferred over $2 billion in Medicaid payments to the state without providing specific details regarding the suspected fraud.[Associated Press]