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Earlier this month, the California Attorney General’s office filed charges against 21 people tied to a $267 million Medi-Cal hospice fraud ring.
The case, dubbed Operation Skip Trace, accuses the defendants of buying stolen personal information on the dark web, enrolling those identities in Medi-Cal through Covered California, and running 14 shell hospice companies that billed the state for end-of-life care that was never provided.
The patients were not dying. In many cases, they did not even live in California. They were names and Social Security numbers pulled from data breaches and turned into billing line items.
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HOW TO SPOT A “RED FLAG” (THE BEHAVIORAL AUDIT)
Keep an eye out for these behavioral shifts in your staff:
Refusal to take leave: Afraid someone will find their “adjustments.”
Unexplained wealth: Buying luxury items that don’t match their known salary.
Working odd hours: Preferring to work alone late at night when no one is watching the system.
“Gatekeeper” behavior: Becoming overly defensive or angry when someone asks to see their records.