CASE FILE: CA-HOSPICE-2024 // STATUS: ACTIVE // TRACKING ALLEGED MEDI-CAL & MEDICARE FRAUD
California is ground zero for alleged hospice fraud. While hospice providers declined 6% nationally, LA County alone saw a 46% increase. Bad actors target hospice because: patients are often isolated, services are difficult to verify, and Medicare pays per-diem rates regardless of actual care provided. The state has implemented a licensing moratorium, but hundreds of questionable providers remain active.
Alleged hospice fraud schemes in California typically involve one or more of these tactics:
Based on enforcement actions and licensing data, these areas have the highest concentration of alleged hospice fraud investigations:
Door-to-door solicitation, marketing at assisted living facilities, or offering gifts/incentives to enroll in hospice care.
Hospices that opened during COVID-19 or experienced unusually rapid patient growth warrant extra scrutiny.
Patients who don't appear to have a terminal illness or who remain on hospice for years without decline.
Family reports little to no visits from hospice staff despite billing for regular services.
Hospice owned by same people who own assisted living, board-and-care, or home health agencies (vertical integration for kickbacks).
Multiple hospice agencies operating from the same address or using the same contact information.
If you suspect a hospice may be committing fraud, report it to these agencies:
Check if a hospice is properly licensed and certified:
Track ongoing alleged hospice fraud prosecutions and settlements in California:
Access raw data for your own analysis:
Explore all 2,590 licensed hospice facilities in California with risk scoring:
Have data or tips? Email us at cory@thegoatinitiative.org