Nevada's Hospice Fraud Crackdown
Nevada Halts New Hospice and Medicaid Enrollments for Six Months Amid Wide-Ranging Fraud Probe
Nevada Health Authority officials announced a temporary pause on new state licenses for hospice and home-health providers and a moratorium on new Medicaid enrollments while the state probes suspected fraud, with the Medicaid hold lasting at least six months after federal approval. State staff will conduct extensive onsite reviews of Medicaid-enrolled hospice and home-health providers in coordination with the Nevada Attorney General, federal partners, and law enforcement, and officials said the move is meant to prevent continued losses of public funds that can be difficult to recover. Nevada Medicaid Director Ann Jensen and Gov. Joe Lombardo said the action is necessary to stop Medicaid billing and payment fraud and support accountability and possible criminal prosecutions. Local hospice leaders praised the crackdown, describing cases in which patients reportedly went days or weeks without seeing nurses, receiving medications, or getting needed equipment, and said some bad actors appear to have been able to operate through deceptive registrations. Coverage also noted that it was unclear whether the moratorium would apply to new patients, and that some new providers may be able to seek exemptions to support hospice and home-health access in rural and underserved communities. The state’s action comes amid similar efforts at the federal level, including a six-month nationwide CMS moratorium on new Medicare enrollments for hospices and home health agencies suspected of wrongdoing.
Key Points
Gov. Joe Lombardo said the action is intended to confront fraud that “undermin[es] care for those who need it most,” adding: “Bad actors… use hospice and home-health programs as vehicles to steal public funds… Nevada will not tolerate fraud, waste, or abuse in our public programs.”
Nevada Medicaid Director Ann Jensen emphasized that without the pause, the state would keep losing “millions in scarce public resources from being stolen from bad actors who are posing as legitimate, licensed hospice and home health providers.”
Nevada’s announcement noted the financial stakes and recovery difficulty, saying fraudulent providers are “diverting stolen payments to offshore accounts before the state can act,” making losses “nearly impossible to recover.”
FOX5 reported that after California enacted a similar Medicare-focused moratorium in 2022, alleged “bad actors simply moved to other states,” citing Nathan Adelson Hospice’s reported “400% increase in hospice care providers statewide,” and noting there are “300 providers… in Clark County.”
Horizon Care leader Karen Rubel described fraud patterns uncovered through research, saying she found “multiple hospice companies registered at the same address” and that some patients were enrolled in hospice “when we hear that people have never seen a nurse… they haven’t gotten their medications… those are big red flags.”
Sentiment
Mostly NegativePublishers
11
Articles
4
Reach
15
