Dems Disabled Safeguards, Handing $200M to Single Medi-Cal Fraudster [WATCH]

A major fraud case involving California’s medical system is drawing scrutiny after U.S. Attorney Bill Essayli outlined how a single individual was able to steal $200 million in less than a year, citing gaps in oversight and licensing practices.

During an exchange with Jon Scott, Essayli said the scale of the fraud highlights broader concerns about how the state manages its healthcare programs, particularly hospice services tied to Medicare billing.

“Because California does nothing to deter the fraud, and they do nothing to detect and prevent the fraud in the first place,” Essayli said.

He described a case his office prosecuted, adding, “The guy you highlighted that we secured a plea agreement for, he took $200 million from the state of California’s medical system in an 11 month period because they suspended their fraud prevention measures that they had on their website.”

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Essayli emphasized the speed and scale of the scheme.

“So this guy took advantage, $200 million, one guy, 11 months,” he said.

“So just calculate how much fraud you think there actually is in the state of California.”

Scott pointed to data suggesting California has an unusually high concentration of hospice providers.

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“And I was reading statistics a few days ago that suggested something like 1800 hospice centers are located in California out of maybe 6000 in the entire country,” Scott said.

“It’s obviously a very lucrative business in California, for some reason.”

Essayli said the financial incentives tied to the program contribute to the issue.

“It’s very lucrative because they can bill crazy amounts to Medicare, and it just gets paid,” he said.

He argued that the licensing process plays a central role in enabling fraudulent activity.

“But the fundamental flaw is that you shouldn’t be able to get a hospice license that easy,” Essayli said. “California is responsible for administering the hospice program. They issue the licenses, and they issued them out like hot cakes.”

According to Essayli, Los Angeles County accounts for a large share of hospice providers.

“And so LA County has a third of all the hospices in the nation,” he said. “That’s not right, so we want to shut those hospices down.”

Essayli said federal officials are taking steps to address the issue, including efforts to prevent suspicious providers from continuing to bill Medicare.

“We’re working with Dr Oz,” he said. “Dr Oz is actually going into the system and blocking certain providers from being able to bill when we see those red flags.”

He added that the underlying problem stems from how access to the system was granted.

“But let’s be clear, not one fraudster would have gotten $1 but for California, handing them the keys to Medicare with a hospice license,” Essayli said.

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