California hospice CEO tells Congress fraud is on the rise across the country
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The CEO of a California hospice advocacy group told congressional lawmakers Tuesday that fraud in the industry is on the rise nationwide, questioning how many fraudulent providers can continue to operate under the noses of regulators.
Sheila Clark, president and CEO of the California Hospice and Palliative Care Association (CHAPCA) — a nonprofit organization that pushes to improve access to end-of-life care — told the House Ways and Means Committee that some hospices operate in name only, meaning they have no patients or staff.
Clark said the proliferation of hospice and home health care providers is a sign of failures in many regulatory agencies that undermine patient protection and harm taxpayers.
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Sheila Clark, president and CEO of the California Hospice and Palliative Care Association (CHAPCA), testified before Congress on Tuesday about hospital fraud. (House Ways and Means Committee)
“You’d be surprised how many hospices there are… a door you can walk up to in California and nobody’s there. Five months’ worth of mail you can see packed… nobody’s there,” Clark said. “And that passed the poll. How did that happen?”
“How do you put a hospice in a burrito place in California?” laughing. “How do you put hospice in every store in California? All of that had to go through licensing and certification and approval.”
Dr. Lynn Ianni, a licensed psychiatrist with nearly 40 years of clinical experience who also testified, said she was locked out of her Medicare benefits for months after being falsely enrolled in hospice care.
“Imagine being told, essentially, that you’re at the end of your life – when you’re not – and being denied access to care because of that mistake. It was beyond frustrating,” she said. “It was very scary.”
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California State Assemblywoman Alexandra Macedo walked into the Merabi Professional Medical Plaza Building in Van Nuys last month, where she said she found 197 hospices registered at the address. (Sarah Reingewirtz/MediaNews Group/Los Angeles Daily News)
“The Medicare representative gave me the name of the place where I was supposed to be registered,” Ianni added. “I looked it up. It looked legitimate except for the Medicare website, with an NPI number, a CEO’s name, and an address. But the address led to what looked like a shopping mall. The phone number was unanswered.”
Republican lawmakers have called for an investigation into Medicare fraud, particularly in blue states where reports have surfaced detailing hundreds of millions of dollars in fraud.
The hearing comes as the Trump administration has consolidated efforts across the country to combat health care fraud.
The Fraud Enforcement Task Force, led by Vice President JD Vance, recently busted 447 hospices in the Los Angeles area over $600 million in alleged fraud. Another hack led to the indictment of more than a dozen people in a multibillion-dollar scheme in which people who didn’t even die were used to bill taxpayers more than $50 million.
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California Gov. Gavin Newsom has dismissed allegations that his office has failed to take action to combat the issue.
“TRUTH: The state has no role in the Medicare billing or payment process,” his press office wrote in X earlier this month in response to a CBS report on hospice fraud in California. “We’re glad the Trump Admin is taking action against fraud. Now, if only Trump would stop pardoning fraudsters—and hold them accountable—that would be great!”
