One of the state’s leading hospice care providers told Texas legislators that Medicare fraud is rampant across the Lone Star State, with rogue operators billing Medicare for millions in Taxpayer dollars. Testimony revealed that patients are being enrolled into hospice without their knowledge, and at least one provider has as many as 15 hospices operating in a single building, with the same owner.
Hospice Brazos Valley President and CEO Lisa McNair recently testified before the Texas Senate Committee on Health and Human Services and said that the number of registered hospices in Texas has nearly doubled in the last six years. She said there are now more than 1,300 facilities that are licensed to provide comfort to patients in their final days of life, KBTX reported. She told the local news outlet that fraudulent Medicare claims are draining taxpayer dollars and eroding trust in legitimate end-of–life care.
McNair investigated the alleged fraud and found that one owner claimed to operate 15 hospices in a single building. She said that a single 10-patient hospice can generate $60,000 per month in Medicare billing.
“Take 10 patients, multiply that times 15 hospices working under one building, under one owner, and you can do the math. That’s many millions of dollars that’s being frauded from the government,” McNair told reporter Nicole Marino.
She added that some “patients” are not even aware they had been enrolled in hospice care services. The facility simply submits fraudulent bills under the patient’s name.
In another odd statistic, McNair found that some hospices have a 100 percent live-discharge rate. This means that all of their patients who are allegedly enrolled in end-of-life care are miraculously walking out alive.
“You don’t normally come on hospice to live. You come on hospice because you’re at the end of your life. When you have a live discharge rate of 100%, that means every patient that you’ve brought on service, you’re discharging them alive. Why would you do that? Why does that look suspicious? It’s because you’re bringing them on, you’re billing for services. They were never appropriate for hospice,” McNair said.
Following fraud scandals in Minnesota and California, Texas Governor Greg Abbott ordered state agencies to hunt down and stop fraud in the Lone Star State, Breitbart Texas reported. “Waste, fraud, and abuse of taxpayer dollars will not be tolerated and will be punished to the fullest extent of the law in Texas,” the Texas governor stated.
While the January order focused on child-care fraud, the Texas Legislature held hearings in April, taking a broader view of Medicare fraud.
Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Hehmet Oz told the National Press Club that federal oversight will increasingly target Texas hospice agencies, noting that fraudulent actors have been moving from California to other jurisdictions.
Late last year, seven Houston residents were charged in an alleged $110 million hospice fraud scheme, the Department of Justice Inspector General’s office reported. The report states:
According to the 43-count superseding indictment, returned Oct. 5, all seven conspired to fraudulently bill Medicare and Medicaid for more than $110 million for hospice services provided to patients who were not terminally ill. The charges allege Ogudo and Martinez operated United Palliative & Hospice Company, a business that misled elderly patients and their families about services billed to Medicare and Medicaid.
As state and federal investigators widen their focus on Texas, lawmakers face mounting pressure to shut down the loopholes that allowed the hospice industry to become a magnet for fraud. With millions in taxpayer dollars at stake and vulnerable families caught in the middle, regulators now must decide whether Texas will remain a safe haven for rogue operators—or finally bring the system back under control.
Bob Price is the Breitbart Texas-Border team’s associate editor and senior news contributor. He is an original member of the Breitbart Texas team. Price is a regular panelist on Fox 26 Houston’s What’s Your Point? Sunday morning talk show. He also serves as president of Blue Wonder Gun Care Products.