Five arrested in connection to $267 million California hospice fraud
Noe PadillaFive people were arrested by the California Department of Justice in connection with a major health care and hospice fraud scheme in Southern California that defrauded taxpayers of nearly a quarter of a billion dollars, Attorney General Rob Bonta announced on April 9. In total, the state filed charges against 21 people.
The investigation, Operation Skip Trace, which the state's DOJ initiated, uncovered and dismantled a Medi-Cal scheme in which 14 hospice companies purchased personal information of non-California residents on the dark web and enrolled the stolen identities in the state-administered Medicaid program.
How was the California hospice fraud case discovered?
The fraud was initially suspected by the California Department of Health Care Services, which informed the state's DOJ, and it was discovered that no hospice services had ever been rendered at any of the 14 sites. The total fraudulent billing is approximately $267 million.
“Fraud is a direct attack on Medi-Cal members who rely on us for care, and we will not stand for it,” said Michelle Baass, California Department of Health Care Services Director, in the press release. “Our safeguards worked as designed: we identified irregularities early, stopped further improper payments, and suspended the fraudulent providers.”
What were the suspects charged with?
The state's DOJ charged the 21 suspects with conspiracy to commit health care fraud, health care fraud, money laundering, and identity theft, according to Bonta.
“For years, California has led the charge to protect public programs from fraud and abuse,” said Gov. Gavin Newsom in the press release. “We hold accountable to the fullest extent of the law anyone who tries to rip off taxpayers and take advantage of public programs, particularly those as sensitive as hospice care."
Hospice care fraud is a national issue
The topic of California's hospice care fraud has become a major focus of scrutiny by state leadership, members of President Donald Trump's administration, and Newsom's critics.
Notably, Mehmet Oz, also known as Dr. Oz, the administrator of the Centers for Medicare & Medicaid Services, has taken the lead in highlighting the extent of Medicaid fraud throughout the state. In January, Oz and Bill Essayli, the first assistant U.S. attorney for the Central District of California, based in Los Angeles, announced that the federal government would start investigating the fraud.
“You’ve all been following the story in Minnesota, which I do think is the tip of the iceberg,” Dr. Oz said during the press conference on Jan. 9.
Earlier this week, Oz announced that his department had revoked the Medicare authorization of Dr. Rajiv Bhuva, a Los Angeles physician, at the center of a CBS News investigation, in connection with $71 million in hospice charges.
"To all the fraudsters out there stealing from our seniors: run, don’t walk. Because we’re coming after you," Oz wrote on social media.
Newsom and other state leaders have attempted to rebut Oz's criticism and the administration's claims that California has not tried to address fraud statewide.
"If Republicans had been paying attention prior to Trump being in office, they’d know a special session is unnecessary because California has been fighting fraud long before Trump: http://StopFraud.CA.Gov," Newsom's office wrote on an X post on April 9.
During a press conference held on April 9, Bonta emphasized that these arrests are only the latest during his tenure, as the state's Department of Justice has conducted over 290 hospice-related investigations, resulting in the arrest and conviction of over 50 suspects.
"We've been doing this for three years. We've been doing this successfully before certain people in this country decided to think about it for the first time," Bonta said.
"I also want to emphasize that this is a California case, from beginning to end."
For people who suspect hospice fraud, the California attorney general's office recommends submitting a complaint online via the AG's website at https://oag.ca.gov/dmfea/reporting.
Noe Padilla is a Northern California Reporter for USA Today. Contact him at [email protected], follow him on X @1NoePadilla or on Bluesky @noepadilla.bsky.social. Sign up for the TODAY Californian newsletter or follow us on Facebook at TODAY Californian.