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Alongside that surge in providers is a staggering rise in billing practices. Nationally, hospice care averages about $13,200 per patient annually. In Los Angeles County, however, providers are reportedly billing closer to $29,000 per patient. In extreme cases, charges have reached as high as $74,000 per individual, raising serious concerns about potential exploitation of Medicare.
Republican investigators also highlighted what they believe are coordinated schemes designed to maximize payouts. In one case cited in the letter, 18 separate hospice agencies allegedly billed Medicare using a single physician’s identification number. Over a three-year period, those claims added up to nearly $600 million.
The letter details a series of additional warning signs that paint a troubling picture. Multiple hospice businesses reportedly share the same physical addresses, some agencies appear to operate with unusually low patient numbers, and there are documented cases where patients labeled as terminally ill were later discharged alive. Lawmakers argue these patterns point to systemic abuse and weak enforcement mechanisms.
Whistleblower accounts included in the investigation add another layer of concern. According to those reports, California’s licensing process may be so loosely regulated that individuals living overseas have been able to secure hospice licenses. Even more disturbing are allegations that seniors have been unknowingly enrolled in hospice programs, with their Medicare information used for fraudulent billing in exchange for kickbacks.
The potential financial impact is enormous. Estimates suggest that Los Angeles County alone could be responsible for as much as $3.5 billion in fraudulent hospice claims, accounting for roughly 18 percent of hospice-related billing nationwide. If accurate, the scope of the issue could rival some of the largest healthcare fraud scandals in recent history.
California Attorney General Rob Bonta has previously described hospice fraud in the state as “an epidemic,” a statement Republicans are now using to underscore the urgency of the situation and the need for immediate corrective action.
As part of the investigation, the Oversight Committee is demanding extensive documentation dating back to 2019. This includes internal communications between the governor’s office and state health agencies, audit findings, complaint records, and detailed information on enforcement actions taken against hospice providers.
Lawmakers are also drawing parallels to past failures in other states, warning that California could be facing a crisis on a similar scale if decisive action is not taken. The message from Republicans is clear: this is no longer just a policy issue but a full-blown accountability test for state leadership.
With an April 6, 2026 deadline set for document production, the investigation is moving quickly. What emerges in the coming weeks could have significant political consequences, not just for Newsom, but for the broader debate over government oversight, healthcare integrity, and the stewardship of taxpayer dollars.
