David mentioned this topic earlier but I wanted to drill down on the issue of hospice fraud. LA County is the capital of this type of fraud and despite state efforts to get it under control, CBS News investigated and found that things have only gotten worse.
At age 69, Lynn Ianni is a pickleball whiz, zipping from dinks to drives energetically. When she suffered an injury on the court two years ago, she sought physical therapy, and was surprised to learn her Medicare insurance wouldn’t cover it…
“They said, ‘you’re in hospice.’ And I said, ‘what? What are you talking about?” Ianni said. “‘Are you kidding me? Do I look like I’m in hospice?’”
Ianni’s Medicare number had been stolen, and used by a company to fraudulently enroll her in hospice – specialized, compassionate care for terminal patients nearing the end of their lives.
Medicare pays the states for hospice care for end-of-life patients, but the states are responsible for issuing the licenses that allow various providers to operate. Fraudsters seem to have realized this is an easy way to steal government money in California.
Three years ago, California’s state auditor sounded the alarm that Los Angeles County had seen a 1,500% increase in hospice companies since 2010 – more than six times the national average relative to its elderly population.
Auditors estimated LA County hospices overbilled Medicare by $105 million in a single year.
The raw numbers are pretty striking. In 2010, LA County had 109 licensed hospice agencies serving a population of about 1 million elderly people. In 2021 the number of elderly people in the county had increased to 1.4 million but the number of agencies when from 109 to 1,841. And the report indicated the number of new applications kept climbing.
Public Health continues to be flooded with thousands of applications for additional hospice agencies, with the majority coming from Los Angeles County. From 2001 through 2018, Public Health data show it received nearly 1,700 applications for new hospice licenses. However, from just January 2019 to August 2021, Public Health received more than 3,500 licensing applications for new hospice agencies, more than double the number it received in the previous 18 years. More than 2,600, or about 75 percent, of these new hospice applications were for locations in Los Angeles County.
The report notes that LA County alone has “45 times as many hospice agencies as New York and 59 times as many as Florida when considering aged populations.” CBS examined every hospice agency in LA County and found 742 of the 1,800 agencies had red flags for fraud. Hundreds of them are located in a relatively small area of the San Fernando Valley:
Nearly 500 hospices are operating within a 3-mile radius, the densest concentration of agencies in the county.
There are 137 hospices operating along Van Nuys Boulevard alone. More than half of them show signs the state has outlined as indicators of fraud.
89 companies are registered to a single building in Van Nuys…
CBS News reached out to the 56 hospice offices whose state and federal data indicate they have five or more red flags. Many of the phone numbers were either disconnected or went straight to voicemail. One instructed the caller to text a different number, which turned out to be invalid. At several of the businesses, however, the representatives who answered the phones denied any fraud and told CBS News they run legitimate hospices that serve real patients. They objected to any allegation they are part of the fraud in the hospice industry.
Some of these may be real but not all of them. There’s significant fraud happening here and, as mentioned above, it my total more than $100 million a year in LA County alone.
If someone were stealing $100 million from LA County banks, you can bet the SWAT team and the FBI would be prepared to shoot those people dead. But because it’s federal money, it seems no one is really too worked up about it. These crooks just keep stealing year after year and no one bothers to stop them.
Think about it this way. There are 500 hospices operating in a 3 mile radius in the San Fernando Valley? Couldn’t the state put together a task force of people and raid them all over a period of 2-3 weeks? Why hasn’t that happened yet? How many years does it take before someone actually shuts this down?
CBS did what California won’t and actually went to one of the businesses that triggered all of the red flags for fraud. It was immediately obvious this was a fake hospice which seems to have transferred its “patients” to another bogus hospice next door.
Data for one agency, VML, triggered all six state fraud indicators in CBS News’ review, while billing roughly $49,000 per patient, which is about three-and-a-half times the national average. It shares a building with other hospices, and its key personnel overlap with multiple companies.
When CBS News visited the office building where VML was located, it appeared no one was in. Mail could be seen piled at the door…
Right next door was World Health Hospice, Inc., another hospice that triggered five of six state indicators of potential fraud, based on the state’s definitions. When CBS News visited that neighboring hospice office, no one answered the door. Phone calls went unanswered and messages couldn’t be left, because its voicemail had not been set up. That agency had been in operation since 2021, according to state records.
Here’s the CBS News report on this. They deserve credit for digging into this and making California’s complacent officials squirm a bit. I suspect we’re getting this from CBS (and not someone else) because Bari Weiss is in charge.
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