Investigation into Health Care Fraud in Los Angeles

The unassuming, single-story stucco building on a bustling street in the Los Angeles suburbs blended in with nearby apartments and shops. The only notable feature was its heavy oak door with a small security grill.

“Is Dr. Faustina here?” I inquired, noting that this was his officially registered address with the Medical Board.

A face quickly appeared, stating, “He doesn’t work here.”

This response struck me as strange. After all, federal records indicated that numerous home health agencies linked to this address had billed Medicare over $40 million using the Medicare number of 87-year-old Dr. Gilbert Faustina.

Los Angeles County Investigated for Widespread Hospice Fraud

Audits—both state and federal—have highlighted a staggering issue of health care fraud in Los Angeles, with taxpayer losses reaching an estimated $3.5 billion.

Legislators in Washington D.C. are calling for enhanced federal oversight to counteract pervasive fraud, where patients often either receive inadequate care or none at all. There are reports of physicians signing off on care plans without ever meeting their patients. To evade scrutiny, hospices and home health providers may shuffle patients between different agencies.

Dr. Ira Byock, a well-respected authority in home health care, shared some insights on this troubling situation.

“Multiple medical practices, each with different names and licenses, operate from the same address,” he explained. “They tend to serve just a few patients, maintaining operations below Medicare’s required standards. This isn’t mere chance—it’s a deliberate tactic by those perpetuating the fraud.”

What transpired in California is not an isolated incident, but the extent is indeed striking. The state grapples with ghost patients, fictitious companies, offshore owners, and compromised doctors. In fact, with 1,923 hospice providers, Los Angeles County surpasses the total number in 36 other states combined—and is 33 times higher than Florida and New York.

“A shocking 18% of the nation’s home health care expenditures come from Los Angeles County,” remarked Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services. “How is that even feasible?”

This issue has also caught the eye of New York State Representative Claudia Tenney, who reached out to Dr. Oz in November, urging an investigation into providers linked to Dr. Faustina’s provider number.

“Between 2021 and 2024, the home health agency related to this physician billed Medicare approximately $600 million. This includes nearly $210 million just in 2024—a stunning 124% increase from 2021,” she highlighted. The patient count associated with Dr. Faustina has escalated from 9,693 to 29,527 in that time.

“We also explored other home health and hospice programs registered at that same address and found over 550 home health agencies and 250 hospices working with Medicare,” she added, pointing to a particular Van Nuys address notorious for Medicare fraud.

Investigation Launched into California Corruption

Documents obtained by Fox News corroborate Tenney’s concerns and were shared with Dr. Faustina, a dynamic figure who graduated from medical school in 1963. Though his main residence is in Las Vegas, he agreed to discuss the situation from his apartment in Van Nuys.

“Congresswoman Tenney suggests your provider number was used to bill Medicare for $600 million, implying some responsibility on your part,” I posed to him.

He replied, “I don’t know the providers using my Medicare number. I don’t bill. I’ve never billed Medicare for these patients. I just receive $3,000 a month from the agency.”

“At the moment, I’m not seeing any patients. Last month, I reviewed 10 to 15 charts during my visits, which are just one day a week.”

However, records show that 76,000 claims were filed for thousands of patients. Additionally, he reportedly has connections with 18 hospice providers, a claim he denies.

“I have nothing to do with hospice,” he insisted.

A visit to several hospices linked to Faustina revealed many looked more like mailing centers than medical establishments. Some were in poor condition, with no one available to answer the door. Some even concealed their names from signs but continued to bill Medicare from that same address.

Ongoing Scrutiny of Fraud Investigation Expands

One location in Van Nuys hosted over 100 hospice or home health agencies, yet none appeared to have any patients, families, or staff present. There was no external signage indicating a provider’s presence, and access required contacting building management.

In another case, an agency that worked with Dr. Faustina part-time severed ties after discovering that his billing rights with Medicare had been suspended.

This brings up an unsettling thought: Is someone orchestrating a scam using your name? I asked Faustina.

“Absolutely,” he replied. “But it’s not for me; it’s for them.”