Fox News Just Found More Medicare Fraud in California

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Yesterday, CBS News exposed massive Medicare fraud related to hospice in California, specifically Los Angeles County. In fact, the number of hospice agencies in Los Angeles County increased by 1,500 percent since 2010, far beyond the 40 percent increase in the senior population. Dr. Oz, head of the Centers for Medicare and Medicaid, has been sounding the alarm on this for months.

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Now Fox News is investigating fraud being committed, and likely in the name of a doctor who says he has no idea who is billing Medicare for hundreds of millions of dollars using his medical credentials.

Here’s more:

On a busy, gritty street in suburban Los Angeles, the white one-story stucco building looked like any other. Among the apartments, offices, sidewalk bodegas, the only defining feature was the building’s door – a thick, solid slab of dark oak with a small, security grill about six inches square.

“Is Dr. Faustina here,” I asked. “This is his address of record with the medical board.”

 A face appeared in the cutout, “He doesn’t work here.”

That’s odd, I thought, considering multiple home healthcare agencies at this address had billed Medicare more than $40 million dollars using 87-year-old Dr. Gilbert Faustina’s Medicare number, according to federal records.

Yet as multiple state and federal audits have shown, healthcare fraud in Los Angeles is big business, with taxpayer losses estimated at $3.5 billion.

Lawmakers on Capitol Hill are demanding federal inspectors exercise stronger oversight to combat what they call “large scale fraud” with patients receiving inappropriate or nonexistent care, with doctors signing off on patient care plans having never met the patient, and hospice and home health providers using multiple licenses to ‘shuffle’ patients from one agency to another to escape state and federal audits.

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Fox News spoke with Dr. Ira Byock, a home healthcare expert, who said fraudulent home health companies will set up fake locations out of the same address under different names and licenses, often serving only a handful of patients so they can fly under the radar.

And while California is not alone in fraud — we’ve spent months hearing about fraud in Minnesota — the scope of the fraud is much larger. Los Angeles County has 1,923 hospice providers for a population of roughly 9.85 million. New York and Florida have 40 and 58 hospice providers, respectively. The population of New York State is about 20 million, and Florida has about 23.3 million residents.

18 percent of the nation’s home healthcare billing comes out of Los Angeles County, according to Dr. Oz.

Dr. Faustina has not been accused of wrongdoing and denies knowing the providers who are using his Medicare number. He also told Fox News he’s not associated with any hospice, despite being linked to 18 hospice providers.

This report will raise more questions about the rampant Medicare fraud that’s happened on Gavin Newsom’s watch. When CBS broke the story, Newsom’s Press Office X account got defensive, saying he’s taken measures to “combat fraud” in the state. All that means is Newsom signed legislation that suspended the issuance of new licenses to hospice providers. As Fox News and CBS have shown, there are hundreds of hospice agencies still operating in the state, and likely fraudulently.

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