Medicare
Federal charges say some seniors were put on hospice without knowing it. Here is how to check a parent's Medicare record
Prosecutors in Los Angeles charged three hospice schemes with billing Medicare more than $138 million for people who were not terminally ill. Many patients learned they were enrolled only when Medicare or their doctor called.
Key facts
- Prosecutors in Los Angeles charged three hospice schemes that allegedly billed Medicare $138 million-plus for people who were not dying.
- Some patients reportedly learned they were on hospice only when Medicare or their doctor called.
- Families can check a parent's Medicare Summary Notice for hospice claims they never chose.
What happened
On October 22, the Justice Department and the U.S. Attorney's Office in Los Angeles announced charges against 15 defendants in health care fraud cases that prosecutors say add up to about $2 billion in false claims. Three of the cases involve hospice, the Medicare benefit meant for people with a life expectancy of six months or less. Prosecutors say those three schemes billed Medicare more than $138 million for patients who were not terminally ill.
In one case, a Los Angeles man is accused of recruiting seniors at community centers with offers of free medical services, describing the program as "palliative services" rather than hospice, and filling out paperwork without them present. According to the complaint, patients said they had never been diagnosed with the conditions on the claims and found out about their enrollment only when contacted by Medicare or their own doctors. In another case, an 83-year-old physician is accused of signing terminal-illness certifications for people who had not chosen hospice. A third case involves four Sherman Oaks hospices where marketers were allegedly paid $1,500 to $1,800 per referral.
Prosecutors pointed to unusually high rates of patients leaving hospice alive as a warning sign. These are charges only, and every defendant is presumed innocent unless proven guilty in court.
What it means for families
Most hospice providers do careful, compassionate work, and these cases are in California. But the pattern prosecutors describe can happen anywhere: an older adult agrees to a "free" service without understanding it is hospice. That matters because choosing hospice changes how Medicare covers care for the terminal illness, and an enrollment the person never chose can disrupt treatment they still need. Families are often the first to notice.
Picture a father who mentions that a friendly nurse from a "free program" stopped by and had him sign a form. A quick look at his Medicare Summary Notice or his online Medicare account would show whether a hospice is billing in his name. If something looks wrong, his own doctor and 1-800-MEDICARE can help sort it out.
What this means in New York: New Yorkers can check claims the same way, through Medicare Summary Notices or a Medicare.gov account, and report suspected fraud to 1-800-MEDICARE or the HHS Office of Inspector General.
What to do this week
- Open your parent's latest Medicare Summary Notice, or log in at Medicare.gov with them, and look for any hospice or provider names you don't recognize.
- Remind your parent never to sign forms or share a Medicare card for a "free" service without talking to you or their doctor first.
- If a claim looks wrong, call 1-800-MEDICARE or the HHS-OIG hotline at 1-800-HHS-TIPS (1-800-447-8477).
Sources
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