1srelluc
Diamond Member
The FBI arrested a married couple Thursday accused of fraudulently billing Medicare for $7.45 million while running a hospice with a survival rate reported to be more than 97% after five years. They were the first in a series of arrests planned Thursday, federal officials told CBS News.
A high survival rate at a hospice provider is one of a series of red flags identified by state auditors for fraud because most people enter hospice care in the final stages of a terminal illness. In past cases of fraud, operators were found to be using false or stolen identities to collect federal reimbursements for palliative care.
The targets of the early-morning operation were Gladwin and Amelou Gill, a doctor and psychologist who co-own 626 Hospice, which does business as St. Francis Palliative Care, according to the FBI.
The FBI raid took place in the residential neighborhood of San Dimas, California, as FBI SWAT personnel announced over a loud speaker they have an arrest warrant. CBS News was at the Southern California location when the FBI agents executed the first early morning arrests.
Hospice fraud in California has become a major focus of Republicans in Washington, who have been highlighting the problem in political attacks on prominent Democratic state leaders. Vice President JD Vance was recently placed in charge of an anti-fraud initiative.
California officials have told CBS News the issue of hospice fraud is a problem nationwide, but that state law enforcement agents have been investigating the issue and conducting their own enforcement actions over the past several years.
Over 700 of the roughly 1,800 hospices in LA County triggered multiple red flags for fraud as defined by the state, the CBS News analysis revealed. Those key warning signs include low patient counts, excessive billing, staff shared across multiple companies, and supposedly terminally ill patients who were later discharged alive.
Another red flag: multiple hospices clustered in one building, including one office plaza with 89 registered hospices, which patient advocate Sheila Clark called "ground zero" for Medicare hospice fraud.
I swear, I doubt if there are enough federal agents in CA to cover it all.
CA makes squeaky noises about investigating the rank fraud in the Hospice industry but it seems like it's the feds who are doing the heavy lifting.
Gee, I wonder why?
A high survival rate at a hospice provider is one of a series of red flags identified by state auditors for fraud because most people enter hospice care in the final stages of a terminal illness. In past cases of fraud, operators were found to be using false or stolen identities to collect federal reimbursements for palliative care.
The targets of the early-morning operation were Gladwin and Amelou Gill, a doctor and psychologist who co-own 626 Hospice, which does business as St. Francis Palliative Care, according to the FBI.
The FBI raid took place in the residential neighborhood of San Dimas, California, as FBI SWAT personnel announced over a loud speaker they have an arrest warrant. CBS News was at the Southern California location when the FBI agents executed the first early morning arrests.
Hospice fraud in California has become a major focus of Republicans in Washington, who have been highlighting the problem in political attacks on prominent Democratic state leaders. Vice President JD Vance was recently placed in charge of an anti-fraud initiative.
California officials have told CBS News the issue of hospice fraud is a problem nationwide, but that state law enforcement agents have been investigating the issue and conducting their own enforcement actions over the past several years.
Over 700 of the roughly 1,800 hospices in LA County triggered multiple red flags for fraud as defined by the state, the CBS News analysis revealed. Those key warning signs include low patient counts, excessive billing, staff shared across multiple companies, and supposedly terminally ill patients who were later discharged alive.
Another red flag: multiple hospices clustered in one building, including one office plaza with 89 registered hospices, which patient advocate Sheila Clark called "ground zero" for Medicare hospice fraud.
I swear, I doubt if there are enough federal agents in CA to cover it all.
CA makes squeaky noises about investigating the rank fraud in the Hospice industry but it seems like it's the feds who are doing the heavy lifting.
Gee, I wonder why?
