Massive Medicare Fraud Probe in California Links $600M in Billing to Single Doctor's ID
The fraud was exposed through federal audits revealing sham home healthcare companies operating from shared addresses, such as a Van Nuys building housing over 100 agencies with no visible patients or staff, shuffling patients to evade detection.
RWTNews Staff
Federal investigators have uncovered a sprawling Medicare fraud scheme in Los Angeles County, where agencies billed nearly $600 million from 2021 to 2024 using the provider number of 87-year-old Nevada-based doctor Gilbert Faustina, who denies any involvement.
The billing, which surged 124% to $210 million in 2024 alone, involved claims for 29,527 patients—up from 9,693 in 2021—with 95% concentrated in Los Angeles County. Faustina, who receives $3,000 monthly from the agencies but claims he does not handle billing or treat the patients, stated he last reviewed charts one day a week and had no knowledge of the hospice providers using his credentials.
The fraud was exposed through federal audits revealing sham home healthcare companies operating from shared addresses, such as a Van Nuys building housing over 100 agencies with no visible patients or staff, shuffling patients to evade detection. A November letter from Rep. Claudia Tenney (R-NY) to CMS Administrator Mehmet Oz highlighted the irregularities, prompting scrutiny. CMS audits showed 18% of national home healthcare billing originates from Los Angeles County, home to 1,923 hospice providers—more than in 36 states combined—contributing to an estimated $3.5 billion in taxpayer losses from regional healthcare fraud.
Medicare has revoked Faustina's billing privileges and suspended payments to associated agencies pending further investigation by state and federal authorities. No arrests have been announced in this case, though it echoes prior California schemes, such as a 2015 kickback operation involving $600 million in fraudulent hospital claims leading to charges against doctors and executives.