California Attorney General's office has charged 21 individuals in a $267 million Medi-Cal hospice fraud scheme. The operation, named "Operation Skip Trace," allegedly involved purchasing stolen personal information from the dark web.
Defendants are accused of using these stolen identities to enroll fake patients in Medi-Cal through Covered California. They then operated 14 shell hospice companies, billing the state for end-of-life care that was never provided. Many of the "patients" did not live in California and were unaware their identities were being used.
Scammers typically pay individuals to put hospice companies in their names, obscuring the true operators. Stolen personal data, including names and Social Security numbers, are acquired from dark web marketplaces. This information is used to create fraudulent hospice patient profiles, leading to continuous billing for nonexistent services as long as the identity remains active.
Los Angeles County has become a focal point for such fraud, with its hospices billing Medicare significantly more than the national average. State auditors identified over 700 hospices in LA County showing multiple fraud red flags. In response, California has revoked hundreds of hospice licenses and imposed a moratorium on new providers.
Unlike typical identity theft, hospice fraud can go unnoticed as it doesn't always trigger credit alerts. Victims may only notice through unexpected Medi-Cal enrollment letters or Medicare Summary Notices listing services they never received.
To combat this, the Centers for Medicare & Medicaid Services advises reviewing Medicare Summary Notices quarterly. Suspicious Medi-Cal activity should be reported to the California Department of Health Care Services. Medicare fraud can be reported to 1-800-MEDICARE or the HHS Office of Inspector General.
Identity theft monitoring services can help detect early signs of fraud by scanning dark web marketplaces and public records for exposed personal information. These services provide alerts for suspicious activity, assisting in fraud resolution and potentially offering identity theft insurance.
Credit monitoring services also track activity across major credit bureaus, alerting individuals to changes that could indicate fraud. Some services offer broader personal data monitoring, including medical IDs, to help catch identity theft schemes more effectively.
This evolving form of fraud highlights the need for vigilance. Scammers are increasingly targeting less-checked systems like Medicare and Medi-Cal, making early detection crucial. Reviewing your healthcare statements and being aware of where your information can be exploited are key defensive measures.