Oversight & Investigations

Subcommittee

Subcommittee on Oversight & Investigations

Responsible for conducting oversight and investigations of any matter related to the jurisdiction of the full committee.

Subcommittees News & Announcements


Mar 6, 2026
Press Release

ICYMI: New York Post Feature: House’s Medicaid fraud probe expands to 10 states – including New York, California: ‘Combat rampant waste’

WASHINGTON, D.C.  – In case you missed it, the  New York Post   recently published an article highlighting letters sent to ten states, authored by Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, inquiring about the rampant waste in their state Medicaid systems and what measures are being taken to address it. In Case You Missed It: “A House committee has launched an investigation into alleged Medicaid fraud in 10 states — including New York and California — demanding records ‘to ensure program integrity in states nationwide,’ The Post can reveal. “The letters, sent March 3 by GOP leaders on the House Energy and Commerce Committee, asked for records and communications from the governors and leaders of state health agencies of New York, California, Colorado, Massachusetts, Maine, Nebraska, Oregon, Pennsylvania, Vermont and Washington State. “Each of the missives drew attention to recent reports or prosecutions of fraudsters in the respective states. “In New York, for example, two individuals linked to adult day cares in Brooklyn and a home health care firm pleaded guilty in January to defrauding taxpayers out of $68 million in Medicaid funds. “Another scheme cited $120 million allegedly stolen from Medicaid and Medicare funds to the owners of Queens-based adult daycare centers and a pharmacy who were taking kickbacks. “The Empire State spent $115.6 billion on Medicaid for almost 7 million people in fiscal year 2025, but the program ‘has continued to grow at unsustainable levels,’ according to Gov. Kathy Hochul’s budget plan for this fiscal year. “Other letters to California, Colorado, Pennsylvania and Nebraska noted massive percentage increases in spending on Medicaid services in recent years. “‘Fraud shouldn’t be a partisan issue,’ Energy and Commerce Chairman Brett Guthrie (R-Ky.) said in a statement. ‘It’s our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care.’ “‘We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity,’ he added. ‘The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.’ “The letters all cited reports of fraudsters bilking taxpayer funds in Minnesota — as well as Trump administration probes that recently led to the withholding of more than $250 million in Medicaid funding. “That fraud was perpetrated through ‘overbilling, falsifying records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, children with autism, people struggling with substance use disorders, and homelessness,’ wrote Guthrie and two other GOP subcommittee chairmen, Rep. John Joyce (R-Pa.) and Rep. Morgan Griffith (R-Va.). “The House Energy and Commerce Committee’s probe comes after a hearing early in February that heard testimony from experts about kinds of fraud schemes — including those with ‘high rates’ of abuse such as Applied Behavioral Analysis (ABA), services for children with Autism Spectrum Disorder (ASD), substance abuse treatment centers, home and community based services and more. “Certified fraud examiner Jessica Gay told the House committee that the vulnerable programs ‘should be on every state’s radar.’ “‘If a state isn’t monitoring ABA services closely, they are likely missing a considerable area where FWA is committed,’ Gay said. “‘Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides,’ Joyce said in a statement. “‘Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system,’ added Griffith. “New York Gov. Kathy Hochul accused the House Energy and Commerce Committee of ‘playing partisan games,’ but vowed to continue to go after ‘bad actors in the Medicaid program.’ “‘Congressional Republicans should learn from Governor Hochul’s dogged efforts to root out waste, fraud and abuse – including sweeping CDPAP reforms that shut down hundreds of wasteful Medicaid middlemen and saved over $2 billion for state and federal taxpayers while protecting home care for those who need it,’ a spokesperson for Hochul said in a statement. “A spokesperson for California Gov. Gavin Newsom insisted the state has tackled Medicaid fraud for years. “‘California holds a strong commitment to protecting taxpayer dollars and the integrity of public programs like Medi-Cal. The state has taken action against Medi-Cal fraud for years and utilizes robust oversight mechanisms to protect the integrity of Medi-Cal programs and preserve public confidence,’ the spokesperson said. “Colorado ‘takes oversight of our Medicaid programs very seriously, and prioritizes finding and rooting out fraud when it occurs, including referring to law enforcement,’ according to a statement from Gov. Jared Polis’ spokesperson. “Reps for the other seven governors’ offices and state health agencies in the states did not immediately respond to a request for comment.”



Mar 5, 2026
Health

E&C Leaders Expand Investigation into Medicaid Fraud Nationwide

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, are continuing their ongoing investigation into waste, fraud, and abuse within Medicaid programs by sending letters to ten additional states to request information and documents on the actions each state is taking to strengthen Medicaid program integrity. These requests come amidst reports and law enforcement actions that have demonstrated high levels of Medicaid fraud across numerous states. For example, in Massachusetts, a woman pleaded guilty to fraudulently billing MassHealth for $500,000 in Personal Care Attendant, home health, and adult foster care services after enrolling disabled, elderly, and homeless people in services without their knowledge or consent and billing Medicaid as their caretaker despite not providing these services. In Colorado, two individuals were charged in separate cases for defrauding Health First Colorado’s non-emergency medical transportation (NEMT) program. The first defendant allegedly billed over $1 million in NEMT rides—$400,000 of which were billed for rides for herself and family members, and most of which were not associated with transportation to medical appointments. The second defendant billed Health First Colorado for $3.3 million in NEMT rides, including $283,000 for 64 rides for a single beneficiary, $165,000 of which occurred after the beneficiary had died. In Oregon, a woman was sentenced to federal prison for using stolen identities to submit fraudulent health care claims to Oregon’s Medicaid Program, totaling over $3 million and triggering $1.5 million in fraudulent Medicaid reimbursements. In New York, two individuals involved in a Brooklyn-based scheme involving adult day cares and home health  pleaded guilty   to $68 million in Medicaid fraud over a seven-year period. In addition, two men in Queens who owned adult daycare centers and a pharmacy  were recently charged  with $120 million in alleged Medicaid and Medicare fraud schemes. This included illegal kickbacks to Medicaid recipients to fill prescriptions at their pharmacies and enroll in their adult day care. It’s no secret that Medicaid fraud schemes have possibly cost the program billions of dollars annually across the country. These schemes contribute greatly to rising health care costs and strain our health care system, all at the expense of Medicaid beneficiaries and taxpayers. The Committee on Energy and Commerce is committed to rooting out waste, fraud, and abuse in our government health programs like Medicaid to ensure Americans who need them get the quality, affordable care they deserve. Chairmen Guthrie, Joyce, and Griffith issued the following statements regarding the ongoing investigation: “Fraud shouldn’t be a partisan issue. It's our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care , ” said Chairman Guthrie. “ We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity. The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.” "Medicaid was established to ensure the most vulnerable Americans are never left behind. That is why fraud and abuse within Medicaid will not be tolerated. Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides," said Rep. John Joyce, M.D. "Expanding this investigation is part of our responsibility in Congress to ensure that the government upholds the standards it was created to serve. Our Committee will work diligently to strengthen the integrity of the Medicaid system and to ensure that those who engage in fraudulent misuse or abuse are held fully accountable." “Americans support federal health care programs that serve American communities, not fraudsters! Led by the House Committee on Energy and Commerce, this latest series of letters is the next step in our investigations to protect our social safety net programs and secure them for the most vulnerable Americans,” said Rep. Griffith. “Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system.” BACKGROUND: In January, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, wrote to Minnesota Governor Tim Walz and the Temporary Commissioner of Minnesota’s Department of Human Services, Shireen Gandhi, requesting communications, documents, and information to better understand the ongoing Medicaid fraud occurring in the state of Minnesota and actions the state is taking to strengthen program integrity. On February 3, the Subcommittee on Oversight and Investigations held a hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid . During this hearing, expert witnesses testified on common examples of Medicaid fraud schemes and the potential scale of fraud in Medicaid programs nationwide. Now, as part of the Committee’s ongoing efforts to address Medicaid fraud, the Committee sent letters to CA , CO , MA , ME , NE , NY , OR , PA , VT , and WA . Each of these states displayed concerning cases of Medicaid fraud over the last several years. The purpose of this investigation is to assess the extent of fraud in state Medicaid programs and understand what states are doing to address the issue and protect the integrity of Medicaid for Americans. Read More About this Ongoing Investigation: CLICK HERE to read the New York Post's exclusive coverage of the letter.



Feb 20, 2026
Environment

Chairmen Guthrie, Joyce, and Palmer Investigate Failure of DC Water to Address Potomac Sewage Spill

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, and Congressman Gary Palmer (AL-06), Chairman of the Subcommittee on Environment sent a letter to David Gadis, the Chief Executive Officer of DC Water requesting information on the failures that led to the spill in the Potomac River and what steps are being taken to ensure it is contained. “The Committee has concerns about how this incident will impact public health, safe drinking water, the environment, interstate commerce, and tourism, all of which fall within the Committee’s jurisdiction,” said Chairmen Guthrie, Joyce, and Palmer. “DC Water is responsible for delivering drinking water and wastewater services to communities in Maryland, Virginia, and the District of Columbia (DC), as well as the federal government, including operation and maintenance of the 54-mile Potomac Interceptor line. The Committee is requesting documents and information from DC Water about what is already being referred to as ‘one of the largest sewage spills in U.S. history.’” Key excerpt from the letter: “Public health warnings have been given for people and pets to avoid contact with water from the Potomac River and to avoid fishing, rowing, and other activities in the area.The warnings to avoid the contaminated water come shortly before the annual Cherry Blossom Festival, which is centered around the Tidal Basin along the Potomac River, and the celebration of the 250th anniversary of the signing of the Declaration of Independence, both of which are expected to attract millions of visitors to the District of Columbia. “An incident of this size and scale presents a significant threat to the public health and welfare of the affected communities, and swift mitigation of these risks is critical. Understanding the nature of how this incident occurred and how future incidents of this scale may be prevented in the future is imperative.” CLICK HERE to read the full letter. BACKGROUND: The letter comes as Washington, DC, Virginia, and Maryland residents continue to deal with the fallout of the spill that occurred on January 19, 2026, and now has resulted in e. coli levels at the spill site measuring at hundreds of times above EPA safety thresholds. As part of its oversight authority, the Committee is requesting information on what DC Water knew about the risk of a potential spill prior to January, documents discussing why emergency contracting was warranted to repair the pipe, why any approved contracts were not implemented, as well as actions DC Water has taken to address the environmental impacts of the spill.


Subcommittee Members

(18)

Chairman Oversight and Investigations

John Joyce

R

Pennsylvania – District 13

Vice Chairman Oversight and Investigations

Troy Balderson

R

Ohio – District 12

Ranking Member Oversight and Investigations

Yvette Clarke

D

New York – District 9

Gary Palmer

R

Alabama – District 6

Dan Crenshaw

R

Texas – District 2

Randy Weber

R

Texas – District 14

Rick Allen

R

Georgia – District 12

Russ Fulcher

R

Idaho – District 1

Diana Harshbarger

R

Tennessee – District 1

Michael Rulli

R

Ohio – District 6

Brett Guthrie

R

Kentucky – District 2

Diana DeGette

D

Colorado – District 1

Paul Tonko

D

New York – District 20

Lori Trahan

D

Massachusetts – District 3

Lizzie Fletcher

D

Texas – District 7

Alexandria Ocasio-Cortez

D

New York – District 14

Kevin Mullin

D

California – District 15

Frank Pallone

D

New Jersey – District 6

Recent Letters


Mar 5, 2026
Health

E&C Leaders Expand Investigation into Medicaid Fraud Nationwide

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, are continuing their ongoing investigation into waste, fraud, and abuse within Medicaid programs by sending letters to ten additional states to request information and documents on the actions each state is taking to strengthen Medicaid program integrity. These requests come amidst reports and law enforcement actions that have demonstrated high levels of Medicaid fraud across numerous states. For example, in Massachusetts, a woman pleaded guilty to fraudulently billing MassHealth for $500,000 in Personal Care Attendant, home health, and adult foster care services after enrolling disabled, elderly, and homeless people in services without their knowledge or consent and billing Medicaid as their caretaker despite not providing these services. In Colorado, two individuals were charged in separate cases for defrauding Health First Colorado’s non-emergency medical transportation (NEMT) program. The first defendant allegedly billed over $1 million in NEMT rides—$400,000 of which were billed for rides for herself and family members, and most of which were not associated with transportation to medical appointments. The second defendant billed Health First Colorado for $3.3 million in NEMT rides, including $283,000 for 64 rides for a single beneficiary, $165,000 of which occurred after the beneficiary had died. In Oregon, a woman was sentenced to federal prison for using stolen identities to submit fraudulent health care claims to Oregon’s Medicaid Program, totaling over $3 million and triggering $1.5 million in fraudulent Medicaid reimbursements. In New York, two individuals involved in a Brooklyn-based scheme involving adult day cares and home health  pleaded guilty   to $68 million in Medicaid fraud over a seven-year period. In addition, two men in Queens who owned adult daycare centers and a pharmacy  were recently charged  with $120 million in alleged Medicaid and Medicare fraud schemes. This included illegal kickbacks to Medicaid recipients to fill prescriptions at their pharmacies and enroll in their adult day care. It’s no secret that Medicaid fraud schemes have possibly cost the program billions of dollars annually across the country. These schemes contribute greatly to rising health care costs and strain our health care system, all at the expense of Medicaid beneficiaries and taxpayers. The Committee on Energy and Commerce is committed to rooting out waste, fraud, and abuse in our government health programs like Medicaid to ensure Americans who need them get the quality, affordable care they deserve. Chairmen Guthrie, Joyce, and Griffith issued the following statements regarding the ongoing investigation: “Fraud shouldn’t be a partisan issue. It's our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care , ” said Chairman Guthrie. “ We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity. The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.” "Medicaid was established to ensure the most vulnerable Americans are never left behind. That is why fraud and abuse within Medicaid will not be tolerated. Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides," said Rep. John Joyce, M.D. "Expanding this investigation is part of our responsibility in Congress to ensure that the government upholds the standards it was created to serve. Our Committee will work diligently to strengthen the integrity of the Medicaid system and to ensure that those who engage in fraudulent misuse or abuse are held fully accountable." “Americans support federal health care programs that serve American communities, not fraudsters! Led by the House Committee on Energy and Commerce, this latest series of letters is the next step in our investigations to protect our social safety net programs and secure them for the most vulnerable Americans,” said Rep. Griffith. “Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system.” BACKGROUND: In January, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, wrote to Minnesota Governor Tim Walz and the Temporary Commissioner of Minnesota’s Department of Human Services, Shireen Gandhi, requesting communications, documents, and information to better understand the ongoing Medicaid fraud occurring in the state of Minnesota and actions the state is taking to strengthen program integrity. On February 3, the Subcommittee on Oversight and Investigations held a hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid . During this hearing, expert witnesses testified on common examples of Medicaid fraud schemes and the potential scale of fraud in Medicaid programs nationwide. Now, as part of the Committee’s ongoing efforts to address Medicaid fraud, the Committee sent letters to CA , CO , MA , ME , NE , NY , OR , PA , VT , and WA . Each of these states displayed concerning cases of Medicaid fraud over the last several years. The purpose of this investigation is to assess the extent of fraud in state Medicaid programs and understand what states are doing to address the issue and protect the integrity of Medicaid for Americans. Read More About this Ongoing Investigation: CLICK HERE to read the New York Post's exclusive coverage of the letter.



E&C Leaders Launch Investigation into Ongoing Medicaid Fraud in Minnesota

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, are requesting communications, documents, and information from Minnesota Governor Tim Walz and the Temporary Commissioner of Minnesota’s Department of Human Services, Shireen Gandhi, to better understand the ongoing Medicaid fraud occurring in the state of Minnesota and actions the state is taking to strengthen program integrity.

The unprecedented fraud scheme in Minnesota, which has potentially been ** ongoing ** since 2013, has revealed a swath of criminal schemes, including overbilling, false records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, people struggling with addiction, and homelessness. Chairmen Guthrie, Joyce, and Griffith issued the following statement regarding ** the letter’s ** content:

“The extensive fraud schemes being perpetrated in Minnesota have wreaked havoc on government-funded health programs. We have an obligation to ensure finite taxpayer dollars are being used responsibly, and that the most vulnerable Americans are not being exploited to the benefit of fraudsters and foreign actors,” said Chairmen Guthrie, Joyce, and Griffith. “As members of Congress and this Committee, our track record has made our continued commitment to ridding government programs of waste, fraud, mismanagement, and abuse clear. This letter is the next step in the Committee’s work to root out fraud and restore program integrity in our federal health programs nationwide.”

The Trump Administration has taken concrete steps to address the fraud being uncovered in Minnesota. Complementary to that work, Congress has a responsibility to oversee federal programs, like Medicaid, to ensure precious dollars and resources are being spent appropriately to deliver quality and necessary care.

BACKGROUND:

Glaring accounts of waste, fraud, and abuse in Minnesota’s Medicaid social service and health programs have resulted in billions of taxpayer dollars going straight to the pockets of fraudsters and foreign actors.

  • Ongoing investigations indicate that fraudulent provider schemes are particularly prevalent in health and community-based service programs, including residential drug and alcohol treatment, home health, housing, and autism service programs.

Unfortunately, Minnesota’s Medicaid program lacks adequate oversight and fraud control measures, and state officials have neglected to swiftly identify and address vulnerabilities in programs.

  • Fraud experts note that fraudsters often target states like Minnesota, which tend to have the “weakest ID checks, fastest payouts, and lowest audit risk,” when looking to establish fraud schemes.

In July 2025, the Working Families Tax Cuts legislation was signed into law by President Trump, including critical provisions to target waste, fraud, and abuse within the Medicaid program—several of which help prevent the fraud schemes that occurred in Minnesota from happening again.

In response to these fraudulent practices, CMS is auditing the Minnesota Medicaid program, freezing provider enrollment, and deferring payments for 14 high-risk programs, including adult companion, rehabilitative mental health services, individualized home supports, residential treatment services, among others—which, alone, cost taxpayers $3.75 billion annually.

CMS recently briefed the Committee on what is currently known about the Medicaid fraud in Minnesota and actions CMS has taken to date. This further underscored the need for the Committee’s oversight to ensure program integrity.



Jan 13, 2026
Press Release

Chairmen Guthrie, Joyce, Griffith, Smith, Schweikert, and Buchanan Ask HHS OIG About Ongoing HHA and Hospice Fraud in Los Angeles County

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means, Congressman David Schweikert (AZ-01), Chairman of the Ways and Means Subcommittee on Oversight, and Congressman Vern Buchanan (FL-16), Chairman of the Ways and Means Subcommittee on Health, authored ** a letter ** to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) requesting a meeting on the concerning evidence detailed in the letter that points to large-scale, ongoing Medicare fraud in Los Angeles County, along with what action is being taken to address the situation.

“The House Committee on Energy and Commerce has an extensive history of digging deeper into matters where program integrity has been compromised. This letter is crucial in our commitment to eliminating waste, fraud, and abuse in federal health care programs,” said Chairmen Guthrie, Joyce, and Griffith. “Republicans have spent much of this Congress furthering legislation to protect our most vulnerable Americans—especially seniors, but our work is not done. Continued oversight is crucial to uphold the integrity of programs that serve our most vulnerable populations. We applaud the ongoing work being conducted by HHS-OIG in cracking down on the fraud that has occurred, and we look forward to addressing the larger-scale scheme that is draining public resources from Americans who need these services the most.”

“Medicare home health and hospice fraud directly undermines the safety and reliability of care for America’s most vulnerable seniors. Auditors have reported an unprecedented jump in home health and hospice fraud in Los Angeles County, California – including one report showing 112 different hospices located at the same physical address. With $1.2 billion in improper payments in home health claims and the Inspector General reporting $198 million in suspected hospice fraud, Gavin Newsom’s California could just as well be another Minnesota,” said Chairman Smith. “The Ways and Means Committee will not hesitate to use our broad oversight authority to get to the bottom of this and protect taxpayers and vulnerable patients against these bad actors.”

BACKGROUND:

Evidence has strongly suggested large-scale Medicare fraud involving home health agencies (HHA) and hospice agencies in Los Angeles County, California, noting that such practices not only drain public resources but also compromise the quality of care provided to patients, especially those most vulnerable populations.

  • The Centers for Medicare and Medicaid Services (CMS) found that the 2023 improper payment error rate for home health claims was 7.7 percent, or about $1.2 billion, in 2023.
  • In terms of hospice care, HHS OIG reported suspected hospice fraud to be an estimated $198.1 million in fiscal year (FY) 2023.
  • CMS has placed HHAs as an area of high risk for Medicare fraud.

Emerging concerns over Medicare fraud in the HHAs and hospice sector highlights heightened activity, specifically in Los Angeles County.

  • From 2019 through June 2023, HHAs in the U.S. decreased from 8,838 to 8,280 (6 percent), while, at the same time, HHAs in Los Angeles County increased from 896 to 1,309 (46 percent).
  • More than 1,400 new Los Angeles County HHAs enrolled in Medicare in the last five years, representing over 50 percent of all HHAs in the state of California and nearly 14 percent of all HHAs in the country.

Based on data from the March 2022 California State Auditor’s Report and from HHS on hospice ownership, Los Angeles County had more than 31 percent of the hospice agencies in the U.S. in 2022.

  • There were approximately 58 million seniors in the U.S. in 2022, with Los Angeles County having approximately 1.49 million seniors (2.5 percent).
  • The report highlighted indicators that included a “rapid, disproportionate growth in the number of hospice agencies” and “excessive geographic clustering of hospice agencies,” noting that 112 different licensed hospice agencies were located at the same physical address.
  • State auditors in California estimated that hospice agencies in Los Angeles County likely overbilled Medicare by $105 million in 2019.

These accounts of widespread fraud occurring in Los Angeles County’s HHAs and hospice agencies have raised concerns about whether home health and hospice Accrediting Organizations (AO) are effectively examining such organizations at the time of their enrollment in Medicare.

  • In November 2024, CMS issued a Quality, Safety, and Oversight memo to surveyors, reminding them to closely inspect hospices’ Medicare enrollment documents to understand changes in ownership and location, but neglecting to encourage AOs to pursue other commonsense antifraud measures.

In April 2025, HHS OIG announced that the Office of Audit Services would compile a report for FY 2026 to identify trends, patterns, and comparisons that could indicate potential vulnerabilities related to new Medicare hospice provider enrollments.

In May 2025, the Health Care Fraud Strike Force—a joint task force of federal, state, and local law enforcement agencies, including HHS OIG—** announced multiple arrests ** following a multi-year investigation into Armenian Organized Crime, which dismantled five hospices in the greater Los Angeles area.

On November 28, 2025, CMS ** announced ** the Calendar Year 2026 Home Health Prospective Payment System Final Rule, providing comments that suggest an interest in addressing the aforementioned accounts of fraud.