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2026-02-04 -Lurid Crime Tales-

California Hospice Fraud Tops Out at $100 Billion - 18% of THE WHOLE COUNTRY'S home health care billing is coming out of Los Angeles County

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Posted by NoMoreBS 2026-02-04 00:00|| E-Mail|| Front Page|| [1857 views ] Top
File under: Malevolent NGO

1 Hospice care sounds like it’s a retirement plan for some. I bet it will be discovered that people are in LA are in hospice care for 20 years in many cases. In other cases hospice might extend into eternity. There are probably 50 doctors there that are acting like Charon, the Styx Ferryman, by designating astronomical numbers of people into hospice care for a modest fee.

Posted by Super Hose 2026-02-03 06:18|| 2026-02-03 06:18|| Front Page Top

2 Got to wonder if you cut all federal spending for any and all programs not covered in the Constitution authority of the national government, how much spending would end.

Posted by Procopius2k 2026-02-03 07:08|| 2026-02-03 07:08|| Front Page Top

3 Along with $18B budget shortfall, California’s bond debt load exceeds $99 billion: Report

Posted by Skidmark 2026-02-03 07:12|| 2026-02-03 07:12|| Front Page Top

4 Yes there is no doubt that there is some fraud in the medical and medical insurance field.

I work in the health insurance field and some of this doesn't sound right. It's common to have a MD oversee/supervise what is called mid level providers (physician assistant, Advanced Practice Registered Nurses and a few others depending on the state). $120 million sounds like a lot , but a skilled facility (SNF) or long term care (LTC) will bill $30,000 per month, per patient and that was Roanoke, VA. Those that are more desirable bill even more. 250 patients x $30,000 x 12 months = $90,000,000. You get a MD and some mid level providers servicing 2 or 3 facilities of 250 patients it gets easy to bill $120 M a year.

Hospice, SNF, LTC and other IP providers require an authorization justifying the length of stay and care being given. So if there is substantial fraud, the company that handles CA would have to be involved and that's a lot of moving parts & people complicit. Probably too many to keep the secret. Hospice means the patient is expected to die within 6 months.

It's entirely possible that the people reporting this don't understand the cost or have the faintest idea of the costs involved.

It wouldn't surprise me at all that CA is paying for illegals to get care.

The $30,000 I mentioned is the amount quoted to me by a billing weenie from a SNF/LTC my father was in. I'll be happy to answer questions people have, mods maybe roll this over to tomorrow to allow for questions?

Posted by Chantry 2026-02-03 18:25|| 2026-02-03 18:25|| Front Page Top

5 And the staff of a SNF< LTC or Hospice are saints and angels. I can't imagine doing that job day after day. They are underpaid, overworked and have to deal with patients that are incontinent, disabled, confused and often in a lot of pain every day.

Posted by Chantry 2026-02-03 18:32|| 2026-02-03 18:32|| Front Page Top

6 #4 - We aim to please, if we aim at all. Rolled over ;-)

Posted by Frank G 2026-02-04 00:07|| 2026-02-04 00:07|| Front Page Top

7 Nice work Frank.

Posted by Besoeker 2026-02-04 00:10|| 2026-02-04 00:10|| Front Page Top

8 Maybe Hotel California was actually about hospice care based on the financials.

Posted by Super Hose 2026-02-04 05:34|| 2026-02-04 05:34|| Front Page Top

9

Note:
I guess the $100 Billion wasn't taxed enough to offset the California $18 Billion 2026 deficit. Given the massive number HOSPICE persons dying and or persons leaving California.

What is allowed by US Medicaid
https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-hospice-rate-letter-FY2025.pdf

At around $34K per person Max per year.
$100B / $34K = 2,941,176 claimed California Hospice Patients out of California stated population of 39.5 million as of July 2025.

Which means about 13.4% would have had to be in Hospice.

BTW: The CAL 2024-2025 Death Data Spreadsheet does not match up

Posted by NN2N1 2026-02-04 07:17|| 2026-02-04 07:17|| Front Page Top

10 For hospice, I think (but am not 100% sure) that to do that, would mean creating 'new' fake patients on a regular basis to replace the existing fake patients that 'died' in hospice. That would require creating a patient, patient history and patient medical history. So patient A is created including personal identifying information and a fake medical history that shows the steps from being 'healthy' to requiring hospice (with most patients dying within 6 months). A quick search suggests that 12 - 15 percent last longer then 6 months. Once patient A dies, a 'new' patient would need to be created to keep money coming in.

I don't know how the fraud is working at such a high level. A doctor/group/facility (All providers have to have a National Provider Identification (NPI) assigned by Medicare) would be required for the referral (and documentation to support it) to hospice. An inpatient stay at a hospital would be expected (guessing at least 75% of the patients would be expected to have that hospital IP stay) before hospice. If you include CA's insurance and the company that manages the insurance, that's a lot of people involved to get past the checks & balances in place to stop fraud and insurance companies are usually very motivated to prevent fraud since it impacts them financially.

Posted by Chantry 2026-02-04 08:24|| 2026-02-04 08:24|| Front Page Top

11 1 The $100 Billion headline is the conclusion of one tweeter. I don't see any basis for this. Dr Oz has estimated the fraudulent billing in LA county as 'possibly $3.5 Billion.

2. The 'patients' were, in general, not real. The fraudsters got hold of their Medicare number and falsified docs. One of the ways they got the Medicare numbers by promising free walkers, scooters and wheelchairs to people in Senior housing or at Senior social events.

Posted by Lord Garth 2026-02-04 08:35|| 2026-02-04 08:35|| Front Page Top

12 I'll add that my employer has a special investigations unit (SIU) to look for fraud and at least some were former police. I'd be surprised if other health insurance companies didn't have a unit to investigate fraud.

Posted by Chantry 2026-02-04 09:00|| 2026-02-04 09:00|| Front Page Top

13 @11 Even $3.5 billion sounds high, but Oz probably has data to support his comment.

Right now investigators from various Federal agencies are looking into CA and where the money is going.

I expect the result of a lot of investigations will become public as we get closer to the mid-terms.

Posted by Chantry 2026-02-04 09:04|| 2026-02-04 09:04|| Front Page Top

14 Showing the Somalis how it's done?

Posted by Grom the Affective 2026-02-04 09:38|| 2026-02-04 09:38|| Front Page Top

15 Rep. Brandon Gill Introduces Bill to Set 25-Year Moratorium on Immigration from Somalia

Posted by Skidmark 2026-02-04 10:01|| 2026-02-04 10:01|| Front Page Top

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