California Health and Human Services Secretary Kim Johnson announced the dismantling of a significant hospice fraud scheme defrauding $267 million from the state during a news conference on April 9, 2026, in Los Angeles.
Home healthcare is vital for millions of Americans, providing essential care through skilled services such as home health nurses and hospice teams. These services are crucial during recovery and end-of-life phases, focusing on trust and personalized care.
Medicare fraud in hospice and home health programs is particularly harmful, threatening vulnerable patients, undermining legitimate providers, and eroding trust in healthcare. Addressing fraud, waste, and abuse remains a key national focus.
Partnering with the National Alliance for Care at Home, the Protecting Seniors and Stopping Fraudsters Act aims to enhance program integrity while ensuring access to care, reducing burdens on legitimate providers.
Concerns over hospice fraud have persisted, highlighted by warning signs and raised by legitimate providers and policymakers. These concerns were voiced during federal hearings, predating national attention. Despite fraudulent activities, many hospice providers offer high-quality, compassionate care daily.
The legislation employs a targeted, data-driven strategy to tackle fraud, maintaining care access for seniors and families. Measures include penalizing providers that fail to report required quality data and conducting site visits for providers with suspicious billing or metrics.
Strengthening accreditation organizations’ role in barring fraudulent operators from Medicare ensures prevention is prioritized alongside detection and removal.
The initiative, supported by Dr. Mehmet Oz, emphasizes smarter oversight and enforcement for Medicare and Medicaid, focusing efforts where most needed.
Collaborative efforts among providers, regulators, and legislators aim to safeguard high-quality care delivery, protecting taxpayer resources. This legislation is a vital step toward achieving these shared goals.
Support from Congress members across party lines is encouraged to fortify oversight, protect patients, and maintain trust in home care services. Ensuring Medicare’s integrity is crucial for preserving patient access to essential services.
Representative Beth Van Duyne of Texas and Jennifer Sheets, CEO of National Alliance for Care at Home, advocate for strengthened healthcare integrity measures to secure safe, trustworthy service provision.