Literature Review

United Palliative & Hospice Care accused of $87M hospice scam Hospice News; by Jim Parker; 7/2/25 Three women associated with Houston-based United Hospice & Palliative Care (UPHC) have been charged with Medicaid and Medicare fraud after allegedly bilking more than $87 million in federal health care funds. The trio includes UPHC owner Dera Ogudo, an UPHC employee Victoria Martinez and a psychiatric hospital employee, Evelyn Shaw, ABC-13 Houston reported. The prosecutor’s indictment also includes an unnamed physician who allegedly received kickbacks for referrals to UPHC. “Ogudo and her co-conspirators preyed on the vulnerable residents of those group homes by enrolling them in hospice services with UPHC when they were not terminally ill,” the indictment indicated.

National Health Care Fraud Takedown results in 324 defendants charged in connection with over $14.6 billion in alleged fraud: Largest Justice Department Health Care Fraud Takedown in history, more than doubles prior record of $6 billion Office of Public Affairs - U.S. Department of Justice, Washington, DC; 6/30/25 The Justice Department today announced the results of its 2025 National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States, for their alleged participation in various health care fraud schemes involving over $14.6 billion in intended loss. The Takedown involved federal and state law enforcement agencies across the country and represents an unprecedented effort to combat health care fraud schemes that exploit patients and taxpayers.Editor's Note: For cases specific to hospice and palliative care, (1) go to our homepage, (2) ;ogin to your newsletter account, (3) use the search engine at the top of our page, using the key word "fraud". We have posted  204 articles about hospice fraud, since we began this format on 1/1/2024. Ongoing, use this search engine as your first "Go To" resource for targeted, timely information.

California man pleads guilty in connection with laundering proceeds of $16M hospice fraud schemeUS Department of Justice press release; 6/23/25A California man pleaded guilty today to laundering more than $4.6 million in connection with a years-long scheme to defraud Medicare of nearly $16 million through sham hospice companies. According to court documents, Mihran Panosyan, ...worked with others to launder the proceeds of a massive Medicare fraud scheme, transferring the fraudulently obtained funds between multiple accounts before spending them. The scheme comprised three parts. First, three of Panosyan’s co-defendants used the identities of foreign nationals no longer in the United States to operate several sham hospice companies... Second, the co-defendants caused the submission of false and fraudulent claims to Medicare for hospice services for patients who were not terminally ill and who never requested nor received hospice services... Third, Panosyan and his co-defendants laundered the proceeds of the scheme to conceal the source of the funds and their control over them... He faces a maximum penalty of 20 years in prison.

Georgia hospice provider reaches $9.2M settlement with DOJ over kickback allegations McKnights Home Care; by Adam Healy; 6/13/25 Georgia-based Creative Hospice Care Inc paid the Department of Justice $9.2 million to settle claims that it entered kickback arrangements with medical professionals in exchange for patient referrals, the DOJ disclosed Wednesday. “Decisions regarding end-of-life care are incredibly difficult and personal, and families must be able to trust the intentions of their chosen providers,” Georgia Attorney General Chris Carr said in a statement. “Those who instead take advantage of the system for their own personal gain will be held accountable.”

Public: If you think you may have experienced Medicare fraud, call 1-800-Medicare to report it. Posted on X; by Mehmet Oz, "DrOzCMS"; 6/2/25 There’s a Medicare scam out there that can really hurt people, and I want to make sure you’re aware! People are targeting older Americans to trick them to sign up for Hospice without their knowledge.   If you think you may have experienced fraud, call 1-800-Medicare to report it.  To learn more, go to http://Medicare.gov/fraud.

CMS budget puts complaint surveys over routine inspections as main nursing home oversight McKnights Long-Term Care; by Kimberly Marselas; 6/2/25 A proposed 2026 Trump administration budget request would shift nursing home survey priorities, further delaying the time between standard inspections at many facilities. The Centers for Medicare & Medicaid Services budget justification published late Friday calls for a $45 million increase in survey spending across multiple sectors next fiscal year. But it also prioritizes complaint surveys in a way that would reduce the availability of surveyors to conduct routine, annual inspections mandated by law. The document from the Department of Health and Human Services shows the percentage of nursing home standard surveys completed each year would fall from 74% in fiscal year 2024 to a projected 65% completion rate in fiscal year 2026. 

2 West Covina women arrested for alleged $4.8 million hospice care fraud CBS News KCAL, Los Angeles, CA; by Julie Sharp; 6/3/25 The U.S. Department of Justice announced that two West Covina women were arrested Tuesday for an alleged scheme to defraud Medicare of $4.8 million with false hospice care claims. One of the women who was arrested is the owner and operator of two West Covina hospices, Golden Meadows Hospice Inc., and D'Alexandria Hospice Inc., which billed Medicare for hospice services for patients who were allegedly not terminally ill.  Between Sept. 2018 and Oct. 2022, owner and operator Normita Sierra, 71, and her alleged accomplice, Rowena Elegado, 55, collected more than $3.8 million from Medicare on false claims, the DOJ said.

CMS rolls out aggressive strategy to enhance and accelerate Medicare Advantage audits CMS Newsroom; Press RElease; 5/21/25 Agency Will Begin Auditing All Eligible Medicare Advantage Contracts Each Payment Year and Add Resources to Expedite Completion of 2018 to 2024 AuditsToday, the Centers for Medicare & Medicaid Services (CMS) announced a significant expansion of its auditing efforts for Medicare Advantage (MA) plans. Beginning immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.

New York bill aims to ban new for-profit hospices amid fraud concerns CBS WRGB-6, Albany, NY; by Lara Bryn; 5/14/25 A new bill awaiting the governor's signature could ban the establishment of new for-profit hospices in New York, a move lawmakers and industry experts say is necessary to improve care quality and prevent potential fraud. ... The bill has already passed in both the state Senate and House. The push for this legislation comes in part due to findings from national studies by the American Medical Association and ProPublica, which highlighted issues in for-profit hospice care. ... Jeanne Chirico, CEO of the Hospice and Palliative Care Association of New York State, said, "To try and make a quick turnaround of profit either through falsifying eligibility records or by fraudulently submitting records for individuals who never even knew they were on hospice." Chirico noted a case where a New York Medicare recipient was unknowingly enrolled in a hospice-certified program based in California. 

California man sentenced to 12 years’ imprisonment in connection with $17m Medicare fraud schemes U.S. Department of Justice - Office of Public Affairs; Press Release; 2/6/25 A California man was sentenced yesterday to 12 years in prison and three years of supervised release for his role in a years-long scheme to defraud Medicare of more than $17 million through sham hospice companies and his home health care company. According to court documents, Petros Fichidzhyan, 44, of Granada Hills, schemed with others to bill Medicare for hospice services that were not medically necessary and never provided. Fichidzhyan and his co-schemers controlled hospice entities and used foreign nationals’ personal identifying information (PII) to conceal the scheme, using the PII to, among other things, open bank accounts, submit information to Medicare, and sign property leases.

Walgreens will pay up to $350M in settlement with DOJ to resolve opioid prescription lawsuit Fierce Healthcare; by Heather Landi; 4/21/25 Walgreens has agreed to pay $300 million to settle allegations from federal prosecutors that it illegally filled millions of invalid prescriptions for opioids and other controlled substances, the Department of Justice (DOJ) announced Monday. The DOJ also alleges that the retail pharmacy chain sought payment for many of those "invalid" prescriptions by Medicare and other federal healthcare programs in violation of the False Claims Act. The settlement amount is based on Walgreens’s ability to pay, the DOJ said, but Walgreens will owe the U.S. an additional $50 million if the company is sold, merged or transferred prior to fiscal year 2032. 

3 major tactics used by hospice scammers Hospice News; by Jim Parker; 4/18/25 Among the numerous tactics that unscrupulous hospices use to commit fraud, three are rising to the forefront. Four states have garnered national attention as fraud hotbeds — Arizona, California, Nevada and Texas. These regions have seen swarms of new hospices emerging and receiving Medicare dollars. Numerous reports of unethical or illegal practices have surfaced, particularly among these new companies. ... One common practice among them is to keep their patient census low to avoid regulators’ attention, Judy Lund Person, principal of the consulting firm Lund Person and Associates, ... Among these providers, three principal tactics are emerging, according to Sheila Clark, president and CEO of the California Hospice and Palliative Care Association. ...

AGG talks: Home health & hospice podcast - Episode 10: Anti-Kickback Compliance for hospice and skilled nursing providers JD Supra; by Arnall Golden Gregory, LLP; 4/3/25 In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss recent OIG guidance on hospice and skilled nursing facility relationships, focusing on anti-kickback risks and fraud concerns. They cover key issues such as the importance of documenting fair market value for any services or space provided, being cautious of payments exceeding Medicaid room and board rates, and avoiding arrangements that appear to be made solely to secure referrals. Bill and Jason also touch on increased oversight and enforcement in the healthcare sector under a new presidential administration.