2026年4月21日 / 美国东部时间下午6:18 / 哥伦比亚广播公司新闻(CBS News)
作者:劳拉·盖勒
劳拉·盖勒是屡获殊荣的调查记者,她于2023年9月加入CBS新闻创新实验室,担任全国调查制片人。
国会议员们要求给出答案,并寻求如何打击临终关怀欺诈的相关建议,这一问题每年给纳税人造成数亿美元的损失。
周二在国会山举行的听证会上,两党代表一致认为,需要加强问责制,以保护医保临终关怀项目,这些项目一直被欺诈运营商盯上,他们经常使用虚假或被盗的身份,为临终护理服务骗取医保报销。
“我们举行此次听证会,是因为美国民众要求就他们被窃取的税款和医保福利给出答案。对于那些欺诈者而言:你们在暗处操作的日子早已一去不复返了,”众议院筹款委员会主席、密苏里州共和党议员杰森·史密斯说道。
周二的听证会持续了四个小时,此前CBS新闻的一项调查曝光了洛杉矶县范围内普遍存在的潜在欺诈迹象,并追踪到一名医生,其医保报销申请涉及126家临终关怀机构。
出席听证会作证的证人林恩·扬尼博士讲述了自己如何成为临终关怀欺诈的受害者:她的医保号码被盗,被冒用注册了她根本不需要的临终关怀服务。扬尼是在因匹克球运动受伤就医时,才发现自己的身份被盗用的。
“我想说的很简单,因为在座各位有能力、有条件,我希望也能托付给你们一项责任,携手采取行动解决这一问题,”扬尼说道。
医保欺诈已成为热门政治话题,共和党和民主党互相指责对方应对此负责。但现实情况是,两党州长领导的州都存在欺诈问题。
“强硬表态无法替代有效的国会应对措施和有力的执法行动,”来自德克萨斯州的民主党众议员劳埃德·多格特说道。
CBS新闻对洛杉矶县目前所有运营中的临终关怀机构的业务和财务记录进行了核查,采用了州审计员认定的潜在欺诈预警指标。
分析结果显示,洛杉矶县约1800家临终关怀机构中,有700多家触发了州政府定义的多项欺诈预警信号。
CBS新闻的调查还发现,根据可获取的最新完整年度数据,2024年,洛杉矶县一名名为拉吉夫·布瓦的医生的名字出现在加州126家临终关怀机构近2800名患者的医保报销申请中。布瓦对CBS新闻表示,他对这些数据表示怀疑,并称目前没有法律限制一名医生可以挂靠多少家临终关怀机构。但在简短交流后,他拒绝进一步置评。布瓦目前已被禁止向医保机构报账。
加州临终关怀与姑息治疗协会主席兼首席执行官希拉·克拉克将议员们的注意力引向了倡导者所称的洛杉矶县临终关怀欺诈“重灾区”,她向议员们介绍了那些堆满邮件的空办公室,而这些办公室的所有者却声称在提供临终关怀服务。
当某人被欺诈性地注册为临终关怀服务对象后,很难撤销注册。许多受害者花费数小时寻求帮助,以取消他们根本不需要且被欺诈性绑定的护理服务。此外,注册临终关怀服务通常会导致他们丧失通过医保获取其他必要医疗服务的资格。
克拉克建议国会建立相关机制,让民众能够撤销欺诈性的临终关怀注册,以免他们被困在系统中无法获得其他医疗服务。
“我们需要在准入环节加强执法,我们需要在州一级的执照发放环节加强执法,我们需要在认证、认证机构环节加强执法,”克拉克说道。“我们不能仅仅通过定罪来解决这个问题,我们必须阻止他们进入这个系统。”
议员们还询问了那些并非欺诈分子、正努力为临终患者提供亟需服务的机构将面临的长期后果。
“我们正在重建加州家庭健康和临终关怀体系;如果我们不这么做,这个体系将会崩溃,”克拉克补充道。
凯特琳·休伊-伯恩斯、雷切尔·戈尔德和亚当·山口为本报道提供了协助。
https://www.cbsnews.com/video/congress-probing-hospice-fraud-california-cbs-news-investigation/
Hospice fraud hearing exposes toll of suspected scams: “The American people are demanding answers”
April 21, 2026 / 6:18 PM EDT / CBS News
By Laura Geller
Laura Geller is a multi-award-winning investigative journalist. She joined the CBS News Innovation Lab as a national investigative producer in September 2023.
Lawmakers are demanding answers and looking for recommendations on how to crack down on hospice fraud, a problem costing taxpayers hundreds of millions of dollars.
At a hearing on Capitol Hill Tuesday, representatives on both sides of the aisle agreed they need more accountability to protect the Medicare hospice programs, which have been raided by fraudulent operators who often use fake or stolen names to bill for end-of-life care.
“We are holding this hearing because the American people are demanding answers about the theft of their tax dollars and their Medicare benefits. To the fraudsters: your time operating in the dark is way over,” House Ways and Means Committee Chairman Jason Smith, a Republican from Missouri, said.
Tuesday’s four-hour hearing came after a CBS News investigation uncovered widespread signs of potential fraud across Los Angeles County and tracked a doctor whose Medicare reimbursement claims were spread over 126 hospice providers.
One witness who testified at the hearing, Dr. Lynn Ianni, described how she became a victim of hospice fraud after her Medicare number was stolen and used to enroll in hospice care she did not need. Ianni discovered her identity had been stolen when she sought treatment for a pickleball injury.
“My message is simply because you here have the capacity and the ability, I would like to entrust you with a responsibility as well, to take action by working together to solve this problem,” Ianni said.
Medicare fraud has become a hot political topic, with Republicans and Democrats each blaming the other party for the problem. But the reality is that fraud occurs in states led by governors from both parties.
“Tough talk is just not a substitute for an effective congressional response and effective enforcement,” said Rep. Lloyd Doggett, a Democrat from Texas.
CBS News examined the business and financial records of every hospice currently operating in LA County, applying the same indicators identified by state auditors as potential red flags for fraud.
The analysis revealed that over 700 of the roughly 1,800 hospices in LA County trigger multiple red flags for fraud as defined by the state.
The CBS News investigation also found one Los Angeles County hospice physician’s name, Dr. Rajiv Bhuva, on Medicare claims for nearly 2,800 patients across 126 California hospices in 2024, according to the last full year of available data. Bhuva told CBS News he doubted the figures and said there was no statutory limit to the number of hospices any one physician can staff. But after a brief exchange, he declined to speak further. Bhuva is no longer allowed to bill Medicare.
Sheila Clark, president and CEO of the California Hospice and Palliative Care Association, focused on what advocates call “ground zero” for hospice fraud in LA County, telling lawmakers about empty offices with mail piled up, whose owners purport to be providing hospice services.
When someone is fraudulently enrolled in hospice care, it can be difficult to get unenrolled. Many victims spend hours trying to get someone to help them remove the care they do not need and were fraudulently signed up for. Hospice care enrollment also often disqualifies them from getting other medical care they do need through Medicare.
Clark recommended Congress create a mechanism for people to get out of a fraudulent hospice enrollment, so they’re not left trapped in the system unable to get other care.
“We need better enforcement on entry. We need better enforcement at licensure, at the state level. We need it at the certification, the accreditation agencies,” Clark said. “We’re not going to convict our way out of this. We have to stop them from entering the system.”
Lawmakers asked about the long-term consequences for providers who are not fraudulent and are trying to provide desperately needed services to people at the end of their lives.
“We are rebuilding California home health and hospice; if we don’t do that, it will collapse,” Clark added.
Caitlin Huey-Burns, Rachel Gold and Adam Yamaguchi contributed to this report.
https://www.cbsnews.com/video/congress-probing-hospice-fraud-california-cbs-news-investigation/
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