FBI SWAT teams fanned out across Southern California early Wednesday morning, executing arrest warrants on doctors, nurses, and other healthcare workers accused of running sham hospice operations that bilked Medicare out of tens of millions of dollars. The operation, dubbed “Operation Never Say Die,” targeted nine separate fraud investigations and resulted in eight arrests, with 15 defendants charged in total.
Among those arrested were multiple nurses who allegedly used their credentials to lend legitimacy to fraudulent hospice companies. Federal prosecutors say the schemes followed a disturbing pattern:
- Recruit patients who were not terminally ill,
- Pay them cash to enroll in hospice care,
- Then submit millions in false claims to Medicare for services that were either medically unnecessary or never provided at all.
First Assistant U.S. Attorney Bill Essayli said in a press…
MANAGEMENT & CULTURE (THE “TONE AT THE TOP”)
Fraud thrives in “sloppy” environments where leadership ignores the rules.
- The Fraud Triangle: For fraud to occur, three elements must be present: Pressure (the need for money), Rationalization (thinking “I deserve this”), and Opportunity (weak controls). You can only control the Opportunity.
- Whistleblower Hotline: Provide an anonymous way for staff to report “odd behavior.” Most internal frauds are caught via tips, not audits.
- Background Checks: Conduct credit and criminal record checks for all employees in financial or data-sensitive roles.
- Annual Ethics Training: Make sure every staff member knows that the company has a Zero Tolerance policy toward “borrowing” from petty cash or fudging overtime.