The federal anti-fraud initiative led by Vice President JD Vance has taken significant action against 447 hospices and 23 home health agencies in Los Angeles, which are under suspicion for fraudulent activities involving more than $600 million in federal healthcare payments.
This suspension pauses Medicare and Medicaid payments while investigations unfold. Los Angeles County has been highlighted by both federal and state authorities as a hotspot for hospice-related fraud, exhibiting an unusually high number of providers compared to the national standard.
According to an analysis from CBS News, with figures from the Department of Health and Human Services, around one-third of hospice facilities in Los Angeles show typical indicators of fraudulent conduct.
Notably, LA County is home to nearly 500 hospices within just a 3-mile radius, with 137 located on Van Nuys Boulevard alone. Over half of these establishments raised red flags during reviews.
State auditors, in a 2022 report, noted that “large clusters of providers” in one area might suggest that the supply of services surpasses actual patient needs. Some providers may be billing for services rendered to patients who aren’t in the area or eligible for hospice care.
The billing patterns further underscore these issues, as the average hospice in LA County bills Medicare approximately $29,000 per patient—almost double the national average of $13,200, with some billings reaching as high as $74,000. Several hospices reported no patients yet continued to submit bills to Medicare in 2024.
Estimates indicate that hospice fraud in LA County could amount to a staggering $3.5 billion annually.
The task force’s recent actions reflect a stark increase of 539 percent from the 70 suspensions reported earlier in the month.
Earlier suspensions included 221 providers in the same area. These efforts are in line with the task force’s objectives, set forth during the Trump administration, to root out waste, fraud, and abuse within federal entitlement programs.
No specific names of the suspended hospices or home health agencies have been released yet; the focus remains on overarching data and risk factors rather than specific cases at this juncture, per reports from Fox News.
“Where there is fraud, the task force will find it. We will not stop until every hard-earned taxpayer dollar goes toward the honest Americans who deserve them,” a spokesperson for Vice President Vance stated.
The task force intends to keep reviewing leads and data nationwide, with expectations that the number of suspensions and total suspected amounts will escalate. Suspended providers will be subjected to additional review processes, which could lead to further enforcement actions, including recoupment of improper payments, loss of billing privileges, or even criminal referrals to the Department of Justice.
During the review period, providers can present evidence or appeals, though all payments will remain frozen until the resolution of these matters.
