Hospice Fraud is Becoming a Political Flashpoint

The issue of hospice fraud has been thrown into the political fray as crackdowns from both California and the federal government continue. Hospice care is something that Americans have come to rely on. One point seven million people were enrolled in hospice care for at least a day in 2022, and that number has only grown over time. Medicare pays about $27,000,000,000 for hospice care each year. What does this fraud mean for patients and victims who are caught up in these schemes? And how can families find quality care for their loved ones during such a vulnerable time in their lives?

For that, let’s turn to our panel. Sheila Clark is the president and CEO of the California Hospice and Palliative Care Association. That’s a nonprofit that has over 250 hospice and home health provider members in California. Sheila, welcome to the program. Great. Thank you for having me.

Also with us is doctor Eric Widera, a professor of medicine at the University of California, San Francisco, practicing geriatrics and palliative care. He’s also the cohost of the Jerry Powell podcast. That’s a geriatric and palliative care podcast for health care professionals. Eric, welcome back to the program. I’m a big fan. Thanks for having me.

And Hilary Loeffler is the vice president of policy and regulatory affairs at the National Alliance for Care at Home. They represent home-based care companies and advocate to strengthen hospice and palliative care. She also held several senior roles at the Centers for Medicare and Medicaid Services, including director of the Home Health and Hospice Division and senior advisor in the Center for Program Integrity, which combats waste, fraud, and abuse. Hillary, thanks for joining us. Thanks, Jen. It’s great to be here.

…We have what we have seen three distinct areas since 2019, which is outright identity theft. These scammers are stealing their MIB numbers, their Medicare benefit numbers. They’re more lucrative than a credit card right now. We see a lot of that. We see uninformed consent where they’re going out to health fairs, grocery stores, churches where people go to worship, and they’re tricking them into signing, informed consent. We’re seeing poor care, no care scenarios where they’re just not getting what they need to, you know, be able to be at home, as my colleague, Eric, was talking about. These are things that are the three top areas that we are seeing here in California.