Report 2021-123 Recommendation Responses
Report 2021-123: California Hospice Licensure and Oversight: The State's Weak Oversight of Hospice Agencies Has Created Opportunities for Large-Scale Fraud and Abuse (Release Date: March 2022)
Recommendation for Legislative Action
To address fraud that is likely occurring in Los Angeles County, the Legislature should require Public Health, Health Care Services, DOJ, and Social Services to immediately convene a taskforce to identify, investigate, and prosecute fraud and abuse by hospice agencies in that county. It should also require those four departments to establish a working group to annually meet to conduct a risk assessment of the Medi-Cal hospice program statewide, including performing analyses similar to those we conducted during this audit regarding growth in the number of hospice agencies, clustering of hospice agencies, and instances of medical personnel working at multiple hospice agencies. Because the fraud indicators we identified frequently also involved home health agencies, the four departments should also consider risks related to home health agencies. These departments should adjust their fraud prevention and detection efforts based on the results of this assessment.
Description of Legislative Action
The Budget Act of 2022, SB 154 (Ch. 43, Stats. of 2022) includes $1 million to establish and facilitate a Hospice Fraud Task Force including representation from the California Health and Human Services Agency, State Department of Public Health, State Department of Health Care Services, State Department of Social Services, and Department of Justice. This bill requires the taskforce to work to address fraud in the hospice services industry in California by identifying and investigating fraud and referring identified cases of suspected fraud to the Department of Justice for prosecution. By January 1, 2025, the task force shall provide a recommendation to the Legislature on whether or not the task force should be established permanently to continue its work on an ongoing basis.
- Legislative Action Current As-of: January 2023