Law enforcement agencies in California have arrested 14 people for their involvement in a $4.2 million hospice fraud scheme. The individuals had been associated with two San Bernardino County-based providers — New Hope Hospice, Inc. and Sterling Hospice Care, Inc.
California Attorney General Rob Bonta alleges that these defendants had enrolled patients who were not terminally into hospice care, in some cases without their knowledge or consent.
Each of the accused is charged with multiple felonies, including insurance fraud, conspiracy to commit insurance fraud, and grand theft. Some also face charges of identity theft, money laundering and tax evasion. Two other suspects in the case remain at large.
“End-of-life care is a difficult process for families to endure, and patients should be able to trust that their hospice providers are acting in good faith,” said Bonta in a statement. “The crimes allegedly committed by the defendants against their patients, Medicare, and our state’s Medi-Cal program will not be tolerated.”
Documents filed with the San Bernardino County Superior Court named two married couples who together founded and operated New Hope Hospice and Sterling: Ralph Canales and Rochell Paragados Canales, and Giovanni Ibale and Maureen Ibale.
The California Department of Justice investigated the crimes with assistance from the U.S. Department of Health and Human Services Office of the Inspector General (OIG) and the California Employment Development Department.
California for more than a year has been cracking down on hospice fraud and other regulatory violations.
Earlier this month state legislators proposed a bill that, if enacted, would require signatures from two physicians to recertify a patient for hospice.
Last Fall California lawmakers passed two hospice reform laws placing a moratorium on new licenses in the state and requiring an audit of licensing and oversight processes.
The state sharpened its gaze on the hospice space in the wake of two 2019 OIG reports showing that about 20% of hospices surveyed by regulators or accreditors between 2012 and 2016 had a condition-level deficiency that posed a serious patient safety risk. California and Texas were the states that saw the most serious deficiencies, according to OIG.
The new arrests follow three separate prosecutions initiated in California during 2021 involving May Light Hospice, Excel Hospice, and Mhiramarc Management, LLC.
This article was written by Jim Parker on February 25th, 2022 and can be found here. Please be sure to visit HospiceNews.Com for more articles written by Jim and other quality contributors.