Hospice

Hospice fraud has been around for years but recently it has grown rapidly especially in places like LA County. The first step is to set up a Hospice business and anyone can do this. One of the warnings that fraud is rampant is to find out how many such businesses exist in a given area. For example, in LA County there are 1,925 while in the whole state of Florida there are 53 and in New York State 40. When a person signs up for Social Security, they receive a Medicare Card with their specific number and they are signed up by a Hospice provider. Once eligible, a personalized plan of care is created and services can begin immediately. Often times new applicants are paid a fee to sign up. The federal government covers hospice care through Medicare Part A, which pays nearly 100% of costs for eligible patients with a terminal illness (life expectancy of 6 months or less). This benefit includes care at home, nursing homes, or inpatient facilities, covering nursing, medical equipment, medications for symptom management, and counseling, with no deductibles and minimal to no copayments. The Hospice business then works with corrupted physicians or the hospice provider’s medical director to submit false claims for services that are not rendered. One doctor claimed to have provided services for 1,900 patients and collected $120 million dollars. In 2023 there was $200 million in fraud and 280 licenses have been revoked. So far $3.5 billion in alleged fraud is under investigation in LA County.