The Gold Show with Walt Philips

3:00 pm - 4:00 pm

Anaheim Woman Pleads Guilty in $2.2 Million Medicare Hospice Fraud Scheme

image

An Orange County woman pleaded guilty earlier this week to submitting more than $2.2 million in fraudulent claims to Medicare for hospice services for beneficiaries who were not terminally ill. 

Advertisement

Medicare paid her company more than $2.1 million for those claims.

Lynn Galbraith, 60, of Anaheim, pleaded guilty to one count of healthcare fraud.

According to her plea agreement, Galbraith was the co-owner and operator of the Garden Grove-based Azure Hospice Care Inc. from September 2019 to July 2022. After that time, she became the company’s sole owner until February 2024. During this time, she knowingly and willfully submitted and caused the submission to Medicare for reimbursement of hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less if the illness ran its normal course.

In submitting the false claims to Medicare, Galbraith either knew the beneficiaries did not qualify for hospice or knew that they did not have sufficient medical records supporting a diagnosis and prognosis that qualified them for hospice benefits. She did not routinely coordinate with the beneficiaries’ primary care physicians about their purported conditions or terminal prognoses.

Galbraith knew and intended that Medicare would rely on her false representations that the patients were eligible for hospice services, and that the false representation would cause Medicare to send payment to Azure Hospice Care for the claimed services.

Recommended

Advertisement

For example, in October 2022, Galbraith submitted a claim to Medicare for $6,600 for reimbursement of hospice services provided to a beneficiary, knowing that there was insufficient medical record documentation to establish Medicare hospice eligibility for this beneficiary.

In total, Galbraith submitted a total of approximately $2,266,694 in false claims to Medicare on behalf of Azure Hospice Care. Of this total, Medicare ultimately paid approximately $2,140,606 to Azure.

United States District Judge John A. Kronstadt scheduled a December 3 sentencing hearing, at which time Galbraith will face a statutory maximum sentence of 10 years in federal prison.

Roughly 66 million people in the U.S. use Medicare, which is health insurance for people ages 65 or older. The program’s funding for the Old Age and Survivors’ Insurance trust fund and other similar programs is projected to be insolvent in 2032, according to the Committee for a Responsible Federal Budget.

Advertisement

The United States Department of Health and Human Services Office of Inspector General (HHS-OIG) is investigating this matter.

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division. The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance, to eliminate fraud, waste, and abuse within Federal benefit programs. 

Assistant United States Attorney Rosalind Wang of the Orange County Office is prosecuting this case.

Editor’s Note: Do you enjoy Townhall’s conservative reporting that takes on the radical Left and woke media? Support our work so that we can continue to bring you the truth.

Join Townhall VIP and use promo code FIGHT to receive 60% off your membership.