Sheila Clark - CHAPCA

CHAPCA is a not-for-profit organization with a mission to improve access to quality end-of-life care and educates providers, patients, families in California.

[Medicare.gov @MedicareGov]

It’s Medicare Fraud Prevention Week and we are sharing tips all week to help keep your Medicare safe.
Protecting your personal information is the first step in preventing Medicare fraud. If you suspect Medicare fraud, call 1-800-MEDICARE or https://t.co/1tSCqVYGjs

[Sheila Clark - CHAPCA @CHAPCA01]

@CMS should not rule out extending the hospice and home health enrollment moratorium.
From @CHAPCA01 perspective, we support it.

California has been ground zero for hospice and skilled home health fraud. The scale of the problem has harmed patients, families, taxpayers, and legitimate providers who are doing the work correctly.

This is not about slowing down responsible care. It is about stopping scammers from continuing to exploit gaps in oversight while compliant providers are left to rebuild trust in the system.

Hospice and home health are essential services. That is exactly why program integrity matters.

CMS is right to pause, assess, and strengthen oversight before allowing continued enrollment growth in sectors where fraud has become too widespread to ignore.

The goal must be clear: protect patients, protect access, protect taxpayers, and protect the integrity of legitimate hospice and home health care.

@DrOzCMS Oz Says Extension Of Home Health, Hospice Enrollment Moratorium Possible | https://t.co/RXR86B14iL https://t.co/880rNkumkU

[Sheila Clark - CHAPCA @CHAPCA01]

@DrOzCMS @VP @WHFraudTF @CHAPCA01 CRUSH IT!

[Sheila Clark - CHAPCA @CHAPCA01]

This week, I was in California with CMS to share what CHAPCA members are seeing on the ground following last month’s suspension of fraudulent hospice agencies. I want to share a few key takeaways:

➡️The suspensions were necessary.

Members have seen troubling cases across California, including patients unaware they were enrolled in hospice and families left without care or support when providers abruptly disappeared.

➡️ CMS is engaged and listening.

We shared frontline realities with CMS leadership and appreciate their continued partnership as we work to protect patients and strengthen oversight.

➡️ Members are stepping up.

CHAPCA providers are actively supporting affected patients and families and helping them reconnect with trusted, high-quality care.

Protecting patients and families remains CHAPCA’s highest priority. We will continue advocating for stronger oversight, greater accountability, and meaningful patient protections at every level.

California Hospice and Palliative Care Association - CHAPCA

@DrOzCMS @CHAPCA01

[Sheila Clark - CHAPCA @CHAPCA01]

@CHAPCA01 spoke with @Ana B. Ibarra at CalMatters about the human toll of hospice fraud. It’s worse than most people realize. 

Behind every story of a scam is… 
➡️ A patient denied curative care like physical therapy or cataract surgery. 
➡️ A senior left feeling ashamed for being deceived.  
➡️ A family watching their loved one suffer while trying to help 

California and the federal government must work collaboratively to develop solutions we urgently need. Let’s root out the scammers while enacting regulations that will make it harder for them to enter the system in the first place. 

If you or someone you know has been affected, visit https://t.co/L8kC3WtpGb and call California Senior Medicare Patrol at 855-613-7080.   

Read the full story here: https://t.co/UxXEPDqdLH  

Sham hospice schemes are bilking Medicare — and harming California seniors https://t.co/UxXEPDqdLH

[Ways and Means Committee @WaysandMeansGOP]

Fraud in our health care system isn’t just about dollars, it’s costing lives.

Scammers are enrolling seniors in hospice who aren’t terminal, blocking them from getting the care they actually need and leading to preventable harm.

Cracking down on fraud, waste, and abuse in Medicare isn’t optional. It’s about protecting patients and making sure seniors get the care they deserve.

[DrOzCMS @DrOzCMS]

Results.

[ABC News @ABC]

Federal officials on Thursday arrested eight people they say were involved in various health care fraud schemes totaling $50 million in and around Los Angeles. https://t.co/AsPMke8jkp

[OIG at HHS @OIGatHHS]

HHS-OIG is rooting out hospice fraud that harms Medicare and patients. Watch Special Agent in Charge Robb R. Breeden’s remarks on today’s $50M Southern California health care fraud takedown. Learn more: https://t.co/rHiu67Sw2h

[Sheila Clark - CHAPCA @CHAPCA01]

Medicare fraud in hospice and home health isn’t just a financial issue—it’s a patient safety crisis.

That’s why yesterday, the California Hospice and Palliative Care Association @CHAPCA01 took an important step to protect patients, families, and the integrity of hospice and home health care.

Alongside our partners at @Save Home Health and @Texas Association for Home Care & Hospice, CHAPCA submitted a formal letter to CMS Administrator Dr. Mehmet Oz calling for a statewide moratorium on new hospice and home health enrollments in California. We’re grateful for @DrOzCMS commitment to this issue and look forward to his continued support.

Why a moratorium?

Patients are inappropriately placed on hospice, limiting access to curative care. Fraudulent billing is distorting national payment systems. And rapid, abnormal provider growth signals coordinated fraud networks. This is no longer isolated. It’s systemic.

I spoke with the @LosAngeles Daily News about the letter and our efforts to improve the hospice system for our providers and patients.

You can read the article here: https://t.co/qvXrMkkU5C

You can also read our full press release here: https://t.co/n5zznkcGR8

#CHAPCA #HospiceLeaders #HealthcareIntegrity #Medicare #HospiceCare #SkilledHomeHealth #FraudPrevention #PatientProtection

[Sheila Clark - CHAPCA @CHAPCA01]

@CBSNews Scammers operating in hospice and home health care must be stopped. When individuals steal identities, bill for services that were never provided, or exploit vulnerable beneficiaries, they harm our community and misuse taxpayer dollars. Thank you @CBSNews and @DrOzCMS

[Sheila Clark - CHAPCA @CHAPCA01]

@CHAPCA01 Grateful for the leadership of @DrOzCMS and @CMSGov Kimberly Brandt in taking decisive action to protect Medicare beneficiaries and stop scammers from exploiting the system. Strengthening safeguards like enhanced MBI monitoring helps protect patients, providers, and taxpayers alike. Crushing fraud matters.

MAC MBI Lookup Tool: Keep Your Access During Enhanced Monitoring
CMS identified a concerning trend of malicious actors stealing MBIs and using them to commit Medicare fraud. Some are misusing Medicare Administrative Contractor (MAC) MBI lookup tools. We’re implementing enhanced monitoring controls to prevent this abuse.

What You Need to Know

Only use the MAC MBI lookup tool for people you intend to provide a service or product to that you’ll bill to Medicare. Our enhanced monitoring compares the MBIs you look up against actual claims submitted with NPIs. If we notice an unusually high rate of MBI lookups without associated claims, your access to the lookup tool may be removed.

Take Action to Maintain Access: Complete MAC Portal Updates by May 7

Make sure your MAC portal users are associated with NPIs in your organization on whose behalf they may perform MBI lookups. This helps us verify legitimate use and protects your access to the lookup tool.

[Sheila Clark - CHAPCA @CHAPCA01]

❤️SW

[Sheila Clark - CHAPCA @CHAPCA01]

Shoutout to @SouthwestAir flight WN2385 SMF to MCO! Thank you Captain for getting the dad and his toddler on so they could join mom on their way to @WaltDisneyWorld! 👍

[Sheila Clark - CHAPCA @CHAPCA01]

@SenRickScott thank you for your focus on protecting patients and families In California, we are seeing firsthand how scammers harm patients and families, especially those navigating serious illness and end-of-life care. @CHAPCA01 supports strong oversight and enforcement that holds bad actors accountable while protecting access to legitimate, high-quality hospice care.

[Rick Scott @SenRickScott]

California is GROUND ZERO for so much of the fraud in our health care system, and it’s hurting our seniors.

As Chair of @SenateAging, I’m focused on ending waste, fraud, and abuse and ensuring anyone targeting seniors is held accountable.

[Sheila Clark - CHAPCA @CHAPCA01]

@chapca01 members check your Community Forum for an update on Telehealth Face to Face
President Signs HHS Approps, PBM Reforms, Health Extenders, Telehealth Extension  | https://t.co/y8iHj1GhwH https://t.co/D7aaEx0BKu

[Sheila Clark - CHAPCA @CHAPCA01]

This week, I spoke with FOX News regarding recent reports of criminal activity exploiting hospice services, patients, and families in Los Angeles–based hospices.

During the interview, I centered the discussion on what matters most, beneficiary harm. This remains CHAPCA’s North Star.

These cases are not simply about fraud or misuse of funds. They are about real harm to vulnerable seniors and patients, including inappropriate hospice enrollment, lack of meaningful care, and compromised dignity at the end of life.

I continue to emphasized that:

• Hospice fraud is fundamentally a patient safety and quality-of-care issue.
• Weak oversight allows scammers to exploit beneficiaries who cannot protect themselves.
• Legitimate hospice providers and the patients they serve are harmed when policy responses are broad, reactive, or misdirected.
• Regulatory and enforcement actions must be targeted, balanced, and focused on preventing beneficiary harm while preserving access to appropriate, high-quality hospice care.

CHAPCA supports the efforts of @DrOzCMS and @CAPublicHealth to strengthen oversight, protect beneficiaries, and hold scammers accountable, while ensuring patients continue to have access to high-quality, ethical hospice care.

The purpose of this conversation was to elevate public understanding that protecting beneficiaries, must guide hospice oversight and policy decisions.

Sheila Clark CHAPCA
President and CEO, CHAPCA

[Sheila Clark - CHAPCA @CHAPCA01]

This week, I spoke with FOX News regarding recent reports of criminal activity exploiting hospice services, patients, and families in Los Angeles–based hospices.

During the interview, I centered the discussion on what matters most, beneficiary harm. This remains CHAPCA’s North Star.

These cases are not simply about fraud or misuse of funds. They are about real harm to vulnerable seniors and patients, including inappropriate hospice enrollment, lack of meaningful care, and compromised dignity at the end of life.

I continue to emphasized that:

• Hospice fraud is fundamentally a patient safety and quality-of-care issue.
• Weak oversight allows scammers to exploit beneficiaries who cannot protect themselves.
• Legitimate hospice providers and the patients they serve are harmed when policy responses are broad, reactive, or misdirected.
• Regulatory and enforcement actions must be targeted, balanced, and focused on preventing beneficiary harm while preserving access to appropriate, high-quality hospice care.

CHAPCA supports the efforts of @DrOzCMS and @CAPublicHealth to strengthen oversight, protect beneficiaries, and hold scammers accountable, while ensuring patients continue to have access to high-quality, ethical hospice care.

The purpose of this conversation was to elevate public understanding that protecting beneficiaries, must guide hospice oversight and policy decisions.

Sheila Clark CHAPCA
President and CEO, CHAPCA

[Sheila Clark - CHAPCA @CHAPCA01]

@CHAPCA01 appreciates the inclusion of provider perspectives in your recent article, and I understand why industry groups emphasize partnership and precision in enforcement. That said, I worry that the current framing risks missing the most important part of this story: who is being harmed.

@DrOzCMS Administrator Dr. Mehmet Oz, speaking in Los Angeles with the U.S. Attorney’s Office, described an estimated $3.5 billion in hospice and home health fraud in LA County alone and a sevenfold increase in hospice utilization that he stated cannot occur naturally. Those numbers point to more than regulatory tension. They point to patients and families being exploited at moments of profound vulnerability, often without fully understanding what hospice enrollment means or what care options are being taken away.

In that context, language focused primarily on avoiding burden to providers or being “surgical” in oversight, while understandable, can unintentionally soften the reality CMS is now describing. This is not just an industry issue. It is a patient protection issue, a family trust issue, and a Medicare Trust Fund issue. When fraud becomes normalized, patients lose appropriate care, families lose clarity and confidence, and public trust in hospice is damaged.

Most hospice providers have been calling for bad actors to be removed for years precisely because this kind of conduct harms the people hospice is meant to serve. Clear, direct reporting that keeps patients, families, and taxpayer dollars at the center of the story helps distinguish legitimate care from exploitation and supports meaningful reform.

[Sheila Clark - CHAPCA @CHAPCA01]

I appreciate the inclusion of provider perspectives in your recent article, and I understand why industry groups emphasize partnership and precision in enforcement. That said, I worry that the current framing risks missing the most important part of this story: who is being harmed.

@DrOzCMS Administrator Dr. Mehmet Oz, speaking in Los Angeles with the U.S. Attorney’s Office, described an estimated $3.5 billion in hospice and home health fraud in LA County alone and a sevenfold increase in hospice utilization that he stated cannot occur naturally. Those numbers point to more than regulatory tension. They point to patients and families being exploited at moments of profound vulnerability, often without fully understanding what hospice enrollment means or what care options are being taken away.

In that context, language focused primarily on avoiding burden to providers or being “surgical” in oversight, while understandable, can unintentionally soften the reality @DrOzCMS is now describing. This is not just an industry issue. It is a patient protection issue, a family trust issue, and a Medicare Trust Fund issue. When scammers become normalized, patients lose appropriate care, families lose clarity and confidence, and public trust in hospice is damaged.

Most hospice providers have been calling for scammers to be removed for years precisely because this kind of conduct harms the people hospice is meant to serve. Clear, direct reporting that keeps patients, families, and taxpayer dollars at the center of the story helps distinguish legitimate care from exploitation and supports meaningful reform.