临终关怀机构97%绝症患者存活,被指控骗取745万美元联邦医保资金


2026年4月2日 美国东部时间上午10:18 / 哥伦比亚广播公司新闻

美国联邦官员向哥伦比亚广播公司新闻透露,联邦调查局于周四逮捕了一对夫妇,他们涉嫌在经营一家临终关怀机构期间,以欺诈手段骗取联邦医保745万美元,据报道该机构五年存活率超过97%。此次逮捕是周四计划中的一系列逮捕行动的首起。

临终关怀服务提供者的高存活率是州审计员认定的一系列欺诈风险信号之一,因为大多数人是在绝症的最后阶段才接受临终关怀。在以往的欺诈案件中,经营者被发现使用虚假或被盗身份,为姑息治疗骗取联邦报销款项。

根据联邦调查局的消息,此次清晨突袭行动的目标是格拉德温·吉尔和阿梅卢·吉尔夫妇,他们分别是一名医生和一名心理学家,共同拥有626号临终关怀机构,对外营业名称为圣弗朗西斯姑息治疗中心。

联邦调查局特种武器和战术部队在加州圣迪马斯的居民区展开突袭行动,通过扩音器宣布他们持有逮捕令。哥伦比亚广播公司新闻在联邦调查局人员执行首次清晨逮捕行动时,身处这个南加州地点现场。当时在场的还有特朗普任命的联邦医保系统监管官员穆罕默德·奥兹医生。

联邦调查局于2026年4月2日周四逮捕了一对涉嫌临终关怀护理欺诈的夫妇。/哥伦比亚广播公司新闻

加州的临终关怀欺诈已成为华盛顿共和党议员的重点关注议题,他们一直在利用这一问题对知名民主党州级官员发起政治攻击。副总统JD·万斯近日被任命负责一项反欺诈倡议。

加州官员向哥伦比亚广播公司新闻表示,临终关怀欺诈是全国性问题,但州执法部门过去几年一直在调查该问题并开展自身执法行动。

联邦调查局实施逮捕期间,加州中区联邦检察官比尔·埃塞利与奥兹一同出现在现场。当被问及围绕欺诈问题的政治因素时,埃塞利指出,周四的执法行动是由一名联邦法官批准的,该法官已在本案中签署了逮捕令。

埃塞利向哥伦比亚广播公司新闻表示,官方已确认15名被告,其中一半以上被控涉及临终关怀欺诈。他说,其中一些人目前在狱中,与外部人员勾结实施欺诈。

数百家临终关怀机构的欺诈风险信号

哥伦比亚广播公司新闻数月来一直在调查洛杉矶县临终关怀行业的欺诈问题。此次调查审查了目前在洛杉矶县运营的所有临终关怀机构的业务和财务记录,以识别出2022年州审计报告认定的潜在欺诈预警指标。

哥伦比亚广播公司新闻的分析显示,洛杉矶县约1800家临终关怀机构中,有700多家触发了州方定义的多项欺诈风险信号。这些关键预警指标包括患者人数过低、过度计费、多家公司共用员工,以及据称患有绝症的患者后来被活体出院。

另一项风险信号是多家临终关怀机构聚集在同一建筑内,其中一处办公园区内就有89家注册的临终关怀机构,患者倡导者希拉·克拉克将其称为“联邦医保临终关怀欺诈的中心地带”。

医保欺诈在南加州已是严重问题,但这是一个全国性难题。美国卫生与公众服务部监察长办公室2023年报告显示,疑似临终关怀欺诈总额估计达1.981亿美元。美国民众通过工资扣除和保费缴纳,为面向老年人和残疾人的纳税人资助医疗保健体系做出贡献。

国会监督委员会启动调查

上月,众议院共和党议员宣布国会将对“猖獗的临终关怀欺诈”展开调查,称可能有数千万纳税人资金因向南加州公司的不当付款而流失。在致加州民主党州长加文·纽瑟姆的一封信中,该委员会援引了哥伦比亚广播公司新闻近期的调查报道。

拥有调查权限的共和党主导的众议院监督委员会在致纽瑟姆的信中,要求提供与该州“为检测和预防其联邦资助的临终关怀项目欺诈行为的监督和内部控制”相关的文件。

委员会成员写道:“近期的报道披露了加州临终关怀项目中令人担忧的欺诈活动证据,包括机构向医保超额计费,以及在受益人不知情的情况下欺诈性为其办理参保手续。”

加州总检察长采取行动打击临终关怀欺诈

州总检察长罗布·邦塔表示,其办公室已针对临终关怀行业的100多名被告提起刑事欺诈诉讼,并提起了约24起民事案件。但他承认,还需要采取更多措施。

“我们需要对风险信号做出响应并采取行动,而不仅仅是计数,”身为民主党人的邦塔说,“遗憾的是,我们的主要工作领域是问责方面,包括刑事调查和民事调查,但这些都是在损害已经造成之后才开展的。”

由于州政府未能按时出台新的临终关怀紧急监管规定,该州针对颁发新临终关怀执照的暂停令最近被延长至2027年1月。公共卫生官员表示,他们正在平衡公众反馈,以审核新申请人的资质,并对临终关怀机构追究责任。

邦塔表示,多个机构正在组建专项工作组,以针对这一问题。

“对于仍然感到沮丧的公民,我理解他们的感受,我也和你们一样感到沮丧,请相信我们已经加大了工作力度,”他说,“我们正在加班加点开展预防和问责工作,并且将持续努力,直到加州的临终关怀欺诈问题被彻底根除。”

Hospice where staggering 97% of terminal patients survive is accused of defrauding Medicare for $7.45 million

April 2, 2026 10:18 AM EDT / CBS News

The FBI arrested a married couple Thursday accused of fraudulently billing Medicare for $7.45 million while running a hospice with a survival rate reported to be more than 97% after five years. They were the first in a series of arrests planned Thursday, federal officials told CBS News.

A high survival rate at a hospice provider is one of a series of red flags identified by state auditors for fraud because most people enter hospice care in the final stages of a terminal illness. In past cases of fraud, operators were found to be using false or stolen identities to collect federal reimbursements for palliative care.

The targets of the early-morning operation were Gladwin and Amelou Gill, a doctor and psychologist who co-own 626 Hospice, which does business as St. Francis Palliative Care, according to the FBI.

The FBI raid took place in the residential neighborhood of San Dimas, California, as FBI SWAT personnel announced over a loud speaker they have an arrest warrant. CBS News was at the Southern California location when the FBI agents executed the first early morning arrests. Also on the scene was Dr. Mehmet Oz, the Trump-appointed official who oversees the federal medicare system.

The FBI arrested a couple accused of hospice care fraud on Thursday, April 2, 2026. CBS News

Hospice fraud in California has become a major focus of Republicans in Washington, who have been highlighting the problem in political attacks on prominent Democratic state leaders. Vice President JD Vance was recently placed in charge of an anti-fraud initiative.

California officials have told CBS News the issue of hospice fraud is a problem nationwide, but that state law enforcement agents have been investigating the issue and conducting their own enforcement actions over the past several years.

Bill Essayli, United States Attorney for the Central District of California, joined Oz from the scene as the FBI made these arrests. In response to questions about the politics surrounding the fraud issue, Essayli noted Thursday’s law enforcement actions were approved by a federal judge who signed arrest warrants in the case.

Essayli told CBS News that officials are announcing 15 defendants, with more than half of them accused of hospice fraud. Some of those people are in prison and working with people on the outside to commit the fraud, Essayli said.

Red flags for fraud in hundreds of hospices

CBS News has been investigating fraud in the hospice industry in Los Angeles County for months. The investigation examined business and financial records of every hospice currently operating in LA County to identify operators that showed the warning signs that a 2022 state audit identified as potential indicators of fraud.

Over 700 of the roughly 1,800 hospices in LA County triggered multiple red flags for fraud as defined by the state, the CBS News analysis revealed. Those key warning signs include low patient counts, excessive billing, staff shared across multiple companies, and supposedly terminally ill patients who were later discharged alive.

Another red flag: multiple hospices clustered in one building, including one office plaza with 89 registered hospices, which patient advocate Sheila Clark called “ground zero” for Medicare hospice fraud.

Medicare fraud has been an acute issue in Southern California, but it’s a nationwide problem. The Department of Health and Human Services’ Office of the Inspector General reported in 2023 that suspected hospice fraud totaled an estimated $198.1 million. Americans pay into the taxpayer-funded health care for the elderly and disabled through paychecks and premiums.

Congressional Oversight Committee launches investigation

Last month, House Republicans announced that Congress mounted an investigation into “rampant hospice fraud,” alleging that tens of millions in taxpayer funds may have been lost in improper payments to Southern California companies. In a letter to Gavin Newsom, California’s Democratic governor, the committee cited the recent CBS News investigation.

The Republican-led House Oversight Committee, which has the authority to investigate, wrote to Newsom, asking for documents related to the state’s “oversight and internal controls to detect and prevent fraud for its federally funded hospice programs.”

“Recent reporting has revealed alarming evidence of fraudulent activity in California’s hospice programs, including agencies overbilling Medicare and fraudulently enrolling beneficiaries without their knowledge,” committee members wrote.

California attorney general’s action to combat hospice fraud

State attorney general Rob Bonta says his office has brought criminal fraud cases against more than 100 defendants in the hospice industry and has filed about two dozen civil cases. But he acknowledged that more needs to be done.

“We need to be responsive to the red flags and react to them, not just count them,” said Bonta, a Democrat. “Our main lane is the accountability side, the criminal investigations, the civil investigations. That’s after the damage is done though, unfortunately.”

A moratorium on issuing new hospice licenses in the state was recently extended through January 2027 because the state missed its deadline to enact new emergency regulations for hospices. Public health officials said they are balancing public feedback to vet new applicants and hold hospices accountable.

Bonta said multiple agencies are working on a task force to target the problem.

“So to the citizens that remain frustrated, I understand, I share your frustration, please know that we have increased our efforts,” he said. “We’re working overtime on prevention and accountability, and we will continue until hospice fraud in California is rooted out.”

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