The U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz has issued a public announcement warning against the most common tactics being employed by fraudulent hospice operators.

Program integrity concerns heating up in the hospice space in recent years have regulators increasingly seeking avenues to safeguard patients and their families against unscrupulous activity.

The latest of these efforts came on Wednesday as Oz issued a statement to increase public awareness about the various ways in which Medicare scammers are taking advantage of vulnerable older adults.

“There’s a Medicare scam out there that can really hurt people,” Oz said in a social media post. “People posing as salespeople are targeting older Americans to trick them to sign up for hospice without their knowledge. Your health care needs should be decided between you and your doctor, not a sales person. If you sign that paper, you could be putting your future health care rights at risk.”

Swarms of new hospices have emerged in certain regions in recent years, with some unscrupulous operators receiving federal funding through illegitimate business practices. California, Arizona, Nevada and Texas are the four hotbed states

Fraudulent operators’ marketing strategies have included the use of illegal or unethical tactics, such as enrolling Medicare beneficiaries in hospice care without their knowledge or without providing services.

Scammers have also offered individuals hundreds of dollars in exchange for their Medicare identification beneficiary numbers. They have also offered free cooking and cleaning services, medical equipment, TVs, furniture and home appliances, among other things in exchange for a beneficiary’s Medicare number. Fraudsters have gone door-to-door, communicated via text, calls and emails, and even approached seniors at bingo halls, community centers and other locations.

“No one legitimate is going to come to your door to offer you services covered by Medicare. Please pass this along to everyone you care about. Together, we can crush fraud,” Oz said.

The CMS announcement coincides with national Medicare Fraud Prevention Week, which takes place annually around June 5 to numerically honor when most seniors 65 and older become eligible to enroll/become beneficiaries.

Industry stakeholders and advocacy organizations have thus far applauded CMS’ efforts to increase public attention around hospice program integrity concerns.

Scammers in hospice have reached “crisis levels” in certain high-risk regions, according to California Hospice and Palliative Care Association (CHPACA) President and CEO Sheila Clark.

“Dr. Oz’s leadership sends a clear message: scammers who prey on vulnerable beneficiaries and abuse Medicare resources will be exposed and held accountable,” Clark said in a statement shared with Hospice News. “His public stance on enforcement marks a critical turning point in restoring trust in this essential benefit. Together, we are working to protect patients, caregivers and taxpayers from those who seek to corrupt care delivery.”

Seniors and family caregivers need ample education to combat fraudsters, according to the Hospice & Palliative Care Association of New York State (HPCANYS).

Targeting seriously ill patients and their families with unscrupulous and unethical marketing practices robs individuals of the ability to make informed health care decisions with dignity at the most vulnerable time in their lives, the association indicated.

“Hospice fraud is very real and scammers will stop at nothing to gain your personal information!” HPCANYS said in a recent social media post. “Hospice does not solicit your business. Period. We educate and allow you to make an informed decision for you or a loved one.”

Shining a spotlight on fraudulent activity occurring in the hospice space is crucial to ensure sustainable access, according to the National Partnership for Healthcare and Hospice Innovation (NPHI).

Fraudsters’ unscrupulous marketing strategies have skewed the competitive landscape, making it difficult for legitimate hospice providers to maintain visibility among patients and families. An additional mounting concern has been the implementation of marketing and outreach practices that at times mirror strategies utilized by quality providers.

The fraudulent activity goes beyond billing schemes and impacts the ability for patients and their families to receive quality end-of-life care, according to NPHI.

“Fraud in hospice care is not just a billing issue — it’s a betrayal of trust that exploits patients and undermines the integrity of care for everyone,” NPHI CEO Tom Koutsoumpas said in a social media post. “We’re so pleased to see Dr. Oz bringing national attention to this issue and look forward to continuing to work closely with CMS leadership to protect patients and strengthen our system.”

Recent fraud cases arise

CMS’ announcement comes as two Medicare fraud cases unfold in California.

Two individuals on Tuesday were arrested for their alleged involvement in a $4.8 million Medicare fraud scheme. Accusations include billing Medicare for hospice services for patients who were not eligible during a scheme that lasted from September 2018 to October 2022.

Normita Sierra, owner and operator of Golden Meadows Hospice Inc. and D’Alexandria Hospice Inc. in California, has been charged with nine counts of health care fraud, one count of conspiracy and four counts of illegal remuneration of health care referrals. Other hospice employees allegedly involved include Rowena Elegado, Carl Bernardo and nurse practitioner Relyndo Salcedo.

The employees allegedly worked together to pay marketers to recruit patients to the hospices, knowingly admitting individuals who had not been referred by primary care physicians, according to a statement from the U.S. Department of Justice. The kickbacks were often referred to internally using the code words “girl scout cookies,” and amounted to as much as $1,300 per patient, per month that the patient stayed on hospice service.

If convicted of the charges, Sierra faces a statutory maximum sentence of 10 years in federal prison for each health care fraud count. Sierra and Elegado each face up to five years in federal prison for the conspiracy count and up to 10 years in federal prison for each illegal kickback count.

Another fraud case arose when a federal indictment was recently unsealed, leading to the arrest of a California-based hospice owner and nurse.

The case involves Jessa Zayas, aka Jessa Contreras, former CEO of both Healing Hands Hospice Inc. and Humane Love Hospice. She was also a nurse for the Los Angeles Unified School District while leading the two multimillion-dollar hospice companies.

Zayas was arrested by the FBI late in May for allegedly bilking more than $2.5 million in fraudulent Medicare hospice claims between June 2023 and February 2025. The allegations include billing Medicare for unnecessary and unauthorized hospice services, enrolling ineligible patients using false documentation, using patients’ stolen identities, unauthorized solicitations and fraudulent use of a doctor’s credentials. 

Allegations also included door-to-door marketing tactics, with the fraudulent hospices enrolling patients who were not terminally ill without their knowledge, according to a local news report.