A total of 103 in-home care providers have been charged en masse for allegedly embezzling more than $4.5 million in Medi-Cal fraud support funds by claiming they cared at home for patients who were actually hospitalized.
Notably, on the same day, the U.S. Department of Justice also announced a medical insurance fraud case amounting to about $2 billion in Southern California, including Los Angeles, raising concerns over the issue of fraudulent claims in California’s medical welfare finances.
California Attorney General Rob Bonta announced the results of a massive crackdown targeting the In-Home Supportive Services (IHSS) program. Over the past year of intensive crackdowns, felony charges were applied to 103 care service providers.
They are accused of falsely filling out work hours and claiming Medi-Cal support funds as if they provided home care even though care recipients were hospitalized in hospitals or skilled nursing facilities. During the relevant periods, the hospitalization costs for the hospitals and nursing facilities were also paid by Medi-Cal.
The State Department of Justice cooperated with the Department of Health Care Services (DHCS) to track suspicious cases by analyzing medical billing data and hospitalization records.
Attorney General Bonta emphasized, “Medi-Cal fraud threatens support funds that should go to the most vulnerable residents,” adding, “We will track down illegal activities to the end to protect taxpayers’ money and essential welfare programs.”
IHSS is a system that supports care costs so that elderly and disabled individuals with limited mobility can live at home without being admitted to nursing facilities. It serves more than 900,000 people annually, and its yearly budget reaches about $30 billion.
Suspicious cases of IHSS-related fraud can be reported online through the California Department of Justice website. In addition, toll-free reporting calls or written reports via mail are available through the Medi-Cal Fraud and Elder Abuse Bureau.
Meanwhile, the federal Department of Justice recently uncovered 10 medical insurance fraud cases amounting to about $2 billion in the Southern California area including Los Angeles and indicted 15 people. They are accused of fraudulently billing medical insurance such as Medicare and Medi-Cal by abusing drug addiction treatment facilities and hospices.
