California Attorney General Bonta Announces Felony Charges Against 103 IHSS Providers: Over $4.5 Million in Alleged Medi-Cal Fraud Across 17 Counties
California Attorney General Rob Bonta announced in Los Angeles, Los Angeles County, California, on October 22 that a statewide enforcement effort against fraud in the In-Home Supportive Services (IHSS) program has resulted in felony charges against 103 IHSS providers, who allegedly defrauded Medi-Cal out of over $4.5 million, with affected members living in 17 counties across the state.
According to the California Department of Justice, the alleged scheme involved providers billing Medi-Cal for care hours during periods when the member was admitted to an acute care hospital or skilled nursing facility that was also paid for by Medi-Cal. The state Department of Justice worked with the Department of Health Care Services, which administers Medi-Cal, reviewing referrals generated through data analytics and claims review; DOJ data mining auditors, special agents and special investigators investigated providers from Butte County to San Diego County. The members lived in Butte, Contra Costa, Fresno, Kern, Lake, Los Angeles, Napa, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Santa Clara, Solano, Sonoma and Tulare counties.
IHSS, funded through Medi-Cal, serves over 900,000 seniors and individuals with disabilities annually, allowing beneficiaries to remain in their homes rather than entering long-term nursing facilities. The state says the federally approved home-based model reduces public spending by approximately $100,000 per person annually compared with nursing facility care. Bonta said IHSS enables parents to care for adult children with disabilities and allows elderly individuals to age in place, calling it a vital lifeline for families across the state that his office is protecting; he said the alleged fraud represents a small fraction of California's $30 billion IHSS budget, but any abuse of Medi-Cal jeopardizes funding for the state's most vulnerable residents.
The Division of Medi-Cal Fraud and Elder Abuse, which handled the effort, receives 75 percent of its funding from the U.S. Department of Health and Human Services, totaling $85,882,152 for federal fiscal year 2027, with the remaining 25 percent, $28,627,384, funded by the State of California. Suspected IHSS fraud can be reported to the division's complaint line at (800) 722-0432. The Department of Justice notes that the charges are only allegations, and every defendant is presumed innocent until proven guilty.
Source: GSM · USA (original Chinese edition)
Photo: Los Angeles 市政厅（资料图，加州总检察长此次全州执法结果在 Los Angeles 宣布）。照片：Busition，CC BY 4.0，经 Wikimedia Commons
