Federal agents have arrested a married couple accused of defrauding Medicare bills of $7.45 million while running a hospice in California, where an unusually high number of patients were reported to have survived. The FBI conducted an early morning raid at the home of Dr. Gladwin Gill and psychologist Amelou Gill, who jointly operate 626 Hospice, also known as St. Francis Palliative Care, officials said.High survival rates in hospices are commonly viewed by investigators as a warning sign of fraud, as most people enter hospice care in the late stages of terminal illness. Previous fraud cases have seen operators use false or stolen identities to obtain federal reimbursement for palliative care.These were the first arrests in a planned series by federal authorities, CBS News reports. FBI SWAT personnel conducted the operation in a residential area of ​​San Dimas, California. Also present was Dr. Mehmet Oz, the Trump-appointed official who oversees the federal Medicare system.Bill Essaly, the United States Attorney for the Central District of California, told reporters that 15 defendants are being announced in connection with the broader fraud investigation, more than half of whom are accused of hospice fraud. Some of those charged were already in jail and allegedly worked with people from outside to commit further fraud.“We are enforcing a zero-tolerance policy for criminals who defraud the American taxpayer,” Essaly said.He added: “The defendants arrested this morning who are accused of stealing millions of dollars of health care benefits were caught and now face years in federal prison.”Investigators in Los Angeles County have been sifting through hospice and health care records for months to identify providers that raised red flags for fraud following a 2022 state audit. The review found that more than 700 of the approximately 1,800 hospices in the county had multiple warning signs. These include low patient numbers, excessive billing, shared staff across multiple companies and patients who were discharged alive despite being classified as terminally ill.Another indicator of potential fraud was the clustering of multiple hospices at the same address. One office building alone was found to house 89 registered hospice providers, a site that patient advocate Sheila Clark described as “ground zero” for Medicare hospice fraud.The Republican-led House Oversight Committee recently launched an investigation into “massive hospice fraud”, asking California Governor Gavin Newsom for documents about oversight and internal controls to prevent fraud in federally funded hospice programs.
