House Republicans are ramping up their investigation into California Governor Gavin Newsom, focusing on extensive fraud and abuse within the state’s hospice care system. This initiative follows a letter issued by the House Committee on Oversight and Government Reform.
The communication directed towards Newsom paints a concerning image of a system with inadequate oversight, a dramatic increase in providers, and potential exploitation of at-risk patients. Lawmakers are requesting various documents from state agencies essential for the investigation.
Central to this inquiry is a “well-documented history” of fraudulent activities tied to California’s federally funded hospice services. Despite being aware of credible fraud allegations for at least four years, state officials have not taken adequate measures to prevent it.
One alarming finding noted by lawmakers is the extraordinary proliferation of hospice providers in Los Angeles County. Since 2010, the tally has soared by roughly 1,500 percent, exceeding 2,800 providers statewide, a number vastly higher than the national average and surpassing totals in numerous other states.
This rapid growth has also led to significant spikes in billing. While national average costs for hospice care hover around $13,200 per patient annually, those in Los Angeles County are approaching $29,000 per patient. Disturbingly, some providers have billed as high as $74,000 for individual patients, prompting serious concerns regarding potential Medicare system abuses.
Furthermore, evidence of coordinated schemes has emerged, with multiple providers allegedly sharing a single doctor’s Medicare number to submit thousands of claims totaling nearly $600 million over three years. These actions raise serious red flags about billing practices.
Concerns Over Oversight and Systemic Issues
Additional troubling signs have surfaced, including several hospice agencies operating from identical addresses, abnormally low patient counts, and instances where patients labeled as terminally ill were discharged alive. Such patterns suggest significant failures in oversight.
Whistleblower allegations also indicate that California’s licensing system is so loose that individuals residing overseas can secure hospice licenses. Moreover, fraudsters are reportedly luring seniors into hospice programs often without their consent, using their Medicare details for unauthorized profit.
The financial implications could be staggering. Estimates suggest that Los Angeles County alone might account for $3.5 billion in hospice fraud, representing around 18 percent of all hospice billing in the nation.
California Attorney General Rob Bonta has described hospice fraud in the state as “an epidemic,” a term Republicans are now echoing in their call for enhanced oversight.
The Oversight Committee is demanding detailed records dating back to 2019, including communications between the governor’s office and health agencies, as well as audits and investigations related to hospice providers.
Comparisons to Other States
Lawmakers are also comparing California’s situation to similar fraud crises in states like Minnesota, where poor oversight resulted in significant financial losses. They emphasize that if immediate actions are not taken, California may face a similar predicament.
The letter sets a deadline of April 6, 2026, for the submission of requested materials, indicating that the investigation is progressing rapidly and could expand based on its findings. For now, Republicans are indicating that they view this as a crucial issue requiring urgent attention.
