Investigator Alleges Massive Fraud in California Healthcare Systems

Fox News reports on independent journalist Nick Shirley’s allegations of widespread fraud in California’s hospice and daycare programs. According to the segment, Shirley claims to have uncovered more than $170 million in suspected fraud in systems overseen by Governor Gavin Newsom’s administration. The video also discusses a separate Fox News investigation into alleged exploitation of hospice funds intended for vulnerable seniors in Los Angeles County.

According to Fox News, Shirley’s investigation follows his previous work exposing alleged fraud in Minnesota. In the interview, Shirley alleges that California “allow[s] more fraud to take place than any other state in America” despite being the highest-taxing state. He claims the fraud spans multiple programs, including daycare facilities receiving funds through a program called Cal Works and hospice providers billing Medicare.

The segment details specific allegations about the hospice industry in Los Angeles County. Fox News reports that Shirley claims there has been a “1,000% increase in hospices inside of just the LA area alone” and that “one in $10 for home healthcare” in America goes to the Los Angeles area. In the video, Shirley alleges that suspected fraudsters are “driving around not just $100,000 cars, but literally $200,000 Maybachs” while operating out of “old motel looking” facilities. He claims these operations are “defrauding the American taxpayer like no other thing, like no other place I’ve ever seen.”

Fox News notes that Shirley’s investigative method involves visiting facilities listed as receiving government funds to verify their operations. According to the journalist, when he arrives at these locations, the services or patients allegedly aren’t present. Shirley states in the interview that when he asks operators basic questions about their billing practices or where patients are, “they can’t even answer the questions” and instead “start deflecting, yelling” or fleeing the scene.

The segment addresses Governor Newsom’s office response to the allegations. According to Fox News, when contacted for comment, Newsom’s office referred them to social media posts that the network characterizes as “seemingly making a joke out of the whole situation.” One post quoted in the segment stated: “Wow Nick Shirley finds potential fraud in Donald Trump’s federal Medicare system.” Fox News notes that Newsom imposed a moratorium on new hospice licenses beginning in 2021. Another post from Newsom’s team allegedly mocked Shirley’s investigative methods at daycare centers, which Shirley interpreted as an attempt to paint him negatively.

In Fox News’s Own Words

“Critics say the system is being exploited on a staggering scale and taxpayers, you’re footing the bill for all of it.”

“These fraudsters are driving around not just $100,000 cars, but literally $200,000 Maybachs.”

“If they had nothing to hide, they would just simply answer the questions. Instead, they start deflecting, yelling.”

The allegations raised in this Fox News segment highlight ongoing concerns about oversight of federally funded healthcare programs at the state level. With nearly 2,000 hospice providers in LA County alone according to the report, questions about adequate regulatory controls and fraud detection in California’s healthcare systems remain politically contentious as investigations continue.