California Cracks Down on Hospice Fraud, Aiming to Protect Critical Care Services

Kim Johnson, Secretary of the California Health and Human Services Agency, has announced the dismantling of a significant hospice fraud scheme, which defrauded the state of $267 million. This announcement was made at a news conference in Los Angeles on April 9, 2026.

Home-based care is vital for millions of Americans daily. Whether through a nurse assisting recovery or a hospice team providing end-of-life care, trust in these services is crucial. Such care meets patients in their homes, offering necessary support during critical times. Fraud in Medicare home health and hospice programs is particularly damaging, affecting real individuals, vulnerable people, and legitimate providers, while shaking the public’s trust in essential healthcare services.

Combatting fraud, waste, and abuse in healthcare must remain a top priority at the national level. Collaborating with the National Alliance for Care at Home, Representative Beth Van Duyne supports the Protecting Seniors and Stopping Fraudsters Act. This act is designed to enhance program integrity in home health and hospice care, ensuring that patients maintain access to these crucial services while easing the burden on legitimate providers.

For years, warning signs of hospice fraud were evident. Concerns from legitimate providers, families, and policymakers highlighted gaps in oversight, allowing exploitative practices to persist. These concerns were shared with federal regulators and discussed in Ways and Means Committee hearings well before reaching national attention.

While fraud has gained increased attention, it is important to recognize the dedication of the majority of hospice providers who continue to offer high-quality, compassionate care. The legislation aims to balance efforts by providing the Centers for Medicare and Medicaid Services with tools to enhance oversight and accountability. Measures include penalizing non-compliant providers in quality data submission and requiring site visits for providers showing questionable billing patterns.

Strengthening the role and accountability of accrediting organizations is key to preventing fraudulent operators from accessing Medicare. Stopping bad actors before entry is as critical as removing them once identified. The efforts of Dr. Mehmet Oz and partnerships focusing on improved oversight for Medicare and Medicaid are noteworthy.

Providers, regulators, and lawmakers share a goal of ensuring safe, high-quality care for patients from trusted providers, while safeguarding taxpayer resources. This legislation signifies a significant step toward achieving this goal. It encourages Congress members from all parties to support enhanced oversight, protect patients, and maintain trust in home-delivered care.

Program integrity and patient access should work hand in hand. Protecting Medicare’s integrity is crucial to ensuring access for the patients and families reliant on these services.