Federal agents arrested a married couple Thursday accused of fraudulently billing Medicare for $7.45 million while operating a hospice whose records showed a five-year survival rate above 97 percent. Authorities described the arrests as the first in a series planned that day.
Federal prosecutors and investigators say an unusually high survival rate at a hospice is a red flag because hospice care normally serves patients in the terminal stages of illness. In previous cases, operators exploited false or stolen identities to collect Medicare reimbursements for palliative services.
The initial targets were Dr. Gladwin Gill and Amelou Gill, a psychologist who co-own 626 Hospice, which does business as St. Francis Palliative Care, according to the FBI. SWAT teams executed a raid at the couple’s home in San Dimas, California, announcing an arrest warrant over a loudspeaker. CBS News was on scene; also present was Dr. Mehmet Oz, identified as the federal official overseeing Medicare.
The Justice Department later said eight people, including the Gills, had been arrested and federally charged in the health care and hospice fraud probe. U.S. Attorney Bill Essayli, who spoke at the scene with Oz, said officials ultimately planned to announce 15 defendants and that more than half of those named are accused of hospice-related fraud. Essayli said some incarcerated individuals had been working with outside associates to perpetrate the scheme.
CBS News has been investigating hospice fraud across Los Angeles County for months. Reporters reviewed business and financial records for every hospice operating in the county and screened operators for warning signs identified in a 2022 state audit. Roughly 700 of about 1,800 hospices in the county triggered multiple red flags defined by the audit.
Those indicators include unusually low patient counts, excessive or irregular billing patterns, staff who are listed across multiple companies, and patients who were certified as terminally ill but later discharged alive. Multiple hospices registered at a single address was another concern: investigators found one office plaza that listed 89 separate hospice entities, a location patient advocate Sheila Clark called “ground zero” for Medicare hospice fraud.
Federal officials and watchdogs say the problem extends well beyond Southern California. The Department of Health and Human Services’ Office of Inspector General reported in 2023 that suspected hospice fraud nationwide totaled an estimated $198.1 million.
The issue has also become a focus of congressional Republicans, who have cited hospice fraud in political attacks on California leaders. Last month, House Republicans announced an inquiry into what they called “rampant hospice fraud,” alleging tens of millions of dollars in improper Medicare payments to Southern California companies and pointing to the CBS News findings. The Republican-led House Oversight Committee sent a letter to Governor Gavin Newsom seeking documents about state oversight and internal controls intended to detect and prevent fraud in federally funded hospice programs.
California Attorney General Rob Bonta said his office has brought criminal cases against more than 100 defendants in the hospice industry and filed roughly two dozen civil actions, but acknowledged more work remains. “We need to be responsive to the red flags and react to them, not just count them,” Bonta said, noting increased prevention and accountability efforts.
State regulators recently extended a moratorium on issuing new hospice licenses in California through January 2027 after missing a deadline to adopt new emergency regulations. Public health officials said the pause gives agencies time to vet applicants and hold existing hospices accountable. Bonta said multiple agencies are collaborating on a task force to target fraud and pledged ongoing efforts to root out abusive practices in the hospice industry.