March 31, 2026

California Targeted in House Committee Investigation of Hospice Fraud

Jeremy Avila, Sarah Hall, John Puente, Raja Sékaran Epstein Becker & Green + Follow Contact LinkedIn Facebook X Send Embed

On March 23, 2026, the U.S. House of Representatives’ Committee on Oversight and Government Reform sent a letter to California Governor Gavin Newsom requesting “documents and communications” surrounding the state’s oversight of its federally funded hospice programs.

The letter, signed by Chairman James Comer and two dozen other Republican members of Congress, alleges a “well-documented history of fraud” in California’s hospice programs. The letter cites the following in support of its allegations:

• The disproportionate number of hospice providers relative to Los Angeles County’s senior population (a 1500 percent increase between 2010 and 2022, resulting in a total that is six times the national average);
• The number of hospice providers in Los Angeles County exceeding that of 36 states (and being 33 times greater than the number in the entire state of Florida);
• Alleged Medicare overbilling by $105 million by hospice providers in Los Angeles County in a single year;
• Instances of providers billing Medicare at a rate of $29,000 per patient for hospice patients in Los Angeles County (contrasted against a national average of $13,200 per patient annually);
• Eighteen hospice providers billing Medicare for 76,000 claims totaling nearly $600 million between 2021 and 2024, using a single doctor’s Medicare provider number; and
• An instance where more than 100 hospice and home health care agencies were registered to a single address in Los Angeles. “In California, your administration’s Departments of Public Health, Social Services and Health Care Services all have a role in overseeing federally funded hospice programs,” Chairman Comer’s letter and an accompanying press release state. The letter and press release also express concerns that the Newsom Administration “does not have sufficient internal controls to prevent and detect fraud” and that its Departments of Public Health, Social Services, and Health Care Services are “not conducting proper oversight of these hospice programs” or satisfying their oversight duties relative to federally funded programs.

Governor Newsom’s office responded on March 24 that “California has been cracking down on hospice fraud for years — with a statewide task force, a standing moratorium on new providers, and aggressive enforcement that’s already revoked 280+ licenses and put hundreds more under investigation.”

Recent Developments

The California hospice investigation is the latest in a pattern of investigations by the current Congress into health care fraud and other activities in liberal leaning states. Chairman Comer’s letter, in fact, attempts to draw parallels to Minnesota, alleging that California’s “fraudulent hospice schemes…appear similar to” alleged social services fraud in Minnesota.

As our EBG colleagues recently wrote, the New York Post reported on March 3 that Administrator Mehmet Oz of the Centers for Medicare and Medicaid Services (CMS) is seeking from New York Governor Kathy Hochul the answers to 50 questions regarding efforts to combat fraud in New York’s Medicaid program, including “detailed information regarding program integrity[,] provider screening, and enrollment oversight.”

Whatever the motivations behind these investigations, health care fraud schemes exist: as one example, four California residents were sentenced in November 2025 to jail time and ordered to pay millions in restitution for defrauding Medicare through sham hospice companies after an investigation by the Federal Bureau of Investigation (FBI) and Department of Health and Human Services Office of Inspector General (HHS-OIG).

Scope of Requests

The House Committee letter requests from Governor Newsom—“as soon as possible but no later than April 6, 2026”—all documents and communications “among or between” the Governor’s office and the three state agencies mentioned above, covering California’s Medicare Part A and Medi-Cal hospice programs between January 2019 to the present. The scope of the request includes, but is not limited to the following:

enrollment and verification, licensure and certification, complaints against licensed hospice agencies, investigations, reimbursement requests, audit documentation, audit reports, payment reviews, and regulations that establish the process for verifying the identity and qualifications of hospice agency management personnel.

Finally, the Committee requests all documents and communications between the governor’s office and the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA) covering the integrity of California’s Medi-Cal program. The scope of that request includes, but is not limited to the following:

the number of complaints received about hospice agencies, the number of investigations opened into hospice agencies for provider fraud, as well as abuse or neglect of patients in facilities receiving federal funds, reports about those investigations, the number of prosecutions against hospice providers and audits showing improper billing or fraud.

Takeaways

Stakeholders connected to California’s hospice system will need to be vigilant with respect to compliance—as the states as well as federal government will be on high alert. Hospice providers should be especially aware of the federal (civil) False Claims Act, which prohibits submitting false claims or causing false claims to be submitted to federal health care programs with reckless disregard or deliberate ignorance or actual knowledge of the falsity; the California False Claims Act; the federal Anti-Kickback Statute and California’s state-level analogs; the federal Stark Law; and the California Physician Ownership and Referral Act.

Further, California’s DMFEA issued a consumer alert on hospice fraud in August 2025, warning in particular against schemes that involve:

• Submitting false claims for services not rendered;
• Billing for services that are not medically necessary;
• Engaging in kickback schemes to receive patient referrals; and
• Enrolling and billing for patients who do not meet the criteria for hospice care, including those who are not terminally ill. Hospice compliance programs, in California especially, should include training on the statutes noted above, as well as on fraud detection/prevention, whistleblower protections, and compliance guidelines issued by federal and state agencies. For background, check out EBG’s new podcast on “State AGs in Action: Health Care Enforcement in 2026.”

Epstein Becker Green Staff Attorney Ann W. Parks contributed to the preparation of this post.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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