California couple Gladwin and Amilo Gil arrested for $7.45 million Medicare fraud at hospice with patients’ survival rates ‘unusually high’ – The

Federal agents have arrested a couple accused of fraudulently billing $7.45 million in Medicare bills while running a nursing home where an unusually high number of patients were reported alive in California.

The FBI carried out an early morning raid on the home of Dr. Gladwin Gill and psychiatrist Amilo Gill, who jointly ran 626 Hospice, also known as St. Francis Palliative Care, authorities said.Investigators typically view high nursing home survival rates as a warning sign of fraud, as most people enter hospice care in the final stages of terminal illness. Previous fraud cases have seen operators use fake or stolen identities to obtain federal reimbursements for palliative care.CBS News reported that the arrests were the first in a series planned by federal officials. FBI SWAT personnel carried out the operation in a residential area in San Dimas, California. Also present was Dr. Mehmet Oz, the Trump-appointed official who oversees the federal Medicare system.Bill Essay, U.S. Attorney for the Central District of California, told reporters that 15 defendants have been announced in connection with the broader fraud investigation, with more than half of them charged with nursing home fraud.

Some of the defendants were already in prison and allegedly worked with people abroad to commit further fraud.“We have a zero-tolerance policy against criminals who defraud American taxpayers,” Al-Asili said.“The defendants arrested this morning and accused of stealing millions of dollars in health care benefits have been arrested and now face years in federal prison,” he added.

Investigators in Los Angeles County have sifted through hospice and health care records for months to identify providers showing red flags for fraud following a 2022 state audit.

The review found that more than 700 of the province’s 1,800 nursing homes set off multiple warning signs. This included low patient volumes, excessive billing, employee engagement across multiple companies, and patients being discharged from the hospital alive despite being classified as terminally ill.Another indicator of potential fraud is the clustering of multiple nursing homes at a single address. Only one building was found to house 89 registered hospice providers, a location that patient advocate Sheila Clark described as “ground zero” in Medicare fraud.The Republican-led House Oversight Committee recently launched an investigation into “rampant nursing home fraud,” and asked California Gov. Gavin Newsom to provide documents on oversight and internal controls to prevent fraud in federally funded nursing home programs.