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Hospice Fraud in California — Federal and State Charges, Penalties, and Defense Strategies

Hospice Fraud in California — Federal and State Charges, Penalties, and Defense Strategies
May 9, 2026|White Collar Crime

Hospice fraud is one of the most aggressively prosecuted forms of healthcare fraud in California. Federal and state charges can result in decades in prison and millions in fines.

Hospice fraud involves billing Medicare, Medi-Cal, or private insurers for hospice services that were not provided, were medically unnecessary, or were provided to patients who did not qualify for hospice care. It is one of the most aggressively prosecuted forms of healthcare fraud in Southern California.

Federal charges typically arise under the False Claims Act, the Anti-Kickback Statute, and federal wire fraud and mail fraud statutes. Convictions can result in up to 10 years in federal prison per count, treble damages under the False Claims Act, exclusion from Medicare and Medi-Cal programs, and civil monetary penalties.

California state charges may include Medi-Cal fraud under Welfare & Institutions Code § 14107, grand theft, and insurance fraud. State and federal prosecutors frequently coordinate investigations, meaning a single case can result in charges in both systems simultaneously.

Hospice fraud investigations typically begin with a whistleblower (qui tam) complaint, a Medicare audit, or a referral from the Office of Inspector General. By the time charges are filed, investigators have often spent months or years building their case. Early intervention by an experienced defense attorney is critical.

Defense strategies in hospice fraud cases include challenging the sufficiency of the government's evidence, demonstrating that billing errors were the result of administrative mistakes rather than intentional fraud, negotiating with prosecutors before charges are filed, and contesting the government's damages calculations. Contact Poseidon Defense A.P.C. for a confidential consultation.

Geronimo Gutierrez IV

Founder & Chief Counsel, Poseidon Defense A.P.C.

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