Hospice fraud in California landed under the microscope this week as lawmakers heard from witnesses who say bogus providers are operating openly while regulators look the other way. Testimony from the California Hospice and Palliative Care Association and a victim of false enrollment painted a picture of empty offices being treated as legitimate hospices, and Republican members pushed for tougher enforcement and accountability from state and federal agencies.
Sheila Clark, president and CEO of the California Hospice and Palliative Care Association, told the House Ways and Means Committee that fraud and sham operations are widespread and brazen. She described providers that exist on paper but have no patients or staff, and she asked how those operations could pass inspections and certifications without anyone noticing.
“You’d be amazed at how many hospices… the door you can walk up to in California and there is nobody there. Five months’ worth of mail that you can see stacked… nobody’s there,” Clark said. Her testimony framed the surge of new hospice and home health providers as a symptom of regulatory breakdowns that leave taxpayers exposed and patients unprotected.
Clark didn’t hold back the irony when she described storefront and strip mall listings that function more as mailing addresses than care facilities. “How do you put a hospice in a burrito stand in California?” she quipped. “How do you put a hospice in an entire store in California? That all had to be vetted through licensure and through certification and accreditation.”
Dr. Lynn Ianni, a licensed psychotherapist with nearly four decades of clinical work, testified she was falsely enrolled in hospice and locked out of her Medicare benefits for months. “Imagine being told, in effect, that you are at the end of your life — when you are not — and then being denied access to care because of that error. It was not just frustrating,” she said. “It was terrifying.”
“A Medicare representative gave me the name of the hospice where I was supposedly enrolled,” Ianni added. “I looked it up. It appeared legitimate on the surface—listed on Medicare’s own website, with an NPI number, a named CEO, and an address. But the address led to what looked like a strip mall. The phone number went unanswered.” Her experience underlines how surface-level checks can be misleading and dangerous.
Republican lawmakers emphasized that this is not a one-off problem but a nationwide pattern, especially visible in blue states where regulators have been accused of being slow to act. The Task Force to Eliminate Fraud, led by Vice President JD Vance, recently suspended 447 hospices in the Los Angeles area over more than $600 million in suspected fraud, and separate enforcement actions uncovered schemes that bilked taxpayers out of tens of millions by billing for care that never happened.
The picture that emerged at the hearing was of overlapping failures: lax licensing, weak certification processes, and inadequate federal and state coordination. Republicans argued those failures cost taxpayers and expose vulnerable patients to harm, and they urged Congress and the administration to tighten enrollment rules, improve audits, and increase penalties to deter bad actors.
California’s governor pushed back, with his press office posting on X that “FACT: The state has no role in the Medicare billing or payment process,” and adding, “We are glad the Trump Admin is taking action to combat fraud. Now, if Trump could stop pardoning fraudsters—and hold them accountable—that would be great!” That statement underscored political friction over who is responsible and what steps should be taken next.
Lawmakers left the hearing with a clearer portrait of how easy it has become for sham operations to hide behind paperwork, and Republicans signaled they will press for sustained oversight and enforcement. The goal they described was straightforward: stop fraudulent providers, protect Medicare dollars, and restore basic trust that hospice means real care for real people.
