Dr. Oz warns that hospice fraud in California is widespread, with doctors allegedly being paid to place patients into hospice improperly, costing taxpayers and stripping vulnerable people of necessary care.
News of large-scale Medicare and Medicaid fraud in other states should have made officials pay attention, but the problem clearly reached California’s hospice system. Dr. Oz, who oversees Medicare and Medicaid, says the abuse is real and it’s hitting patients where it hurts most. The allegation is simple and shocking: financial incentives are pushing patients into hospice care they may not need.
Hospice exists to provide comfort for people with terminal conditions who are expected to live six months or less, focusing on symptom relief rather than curative treatment. Families and clinicians rely on that framework to protect dignity at the end of life, so any misuse cuts to the core purpose of care. When the incentives flip, patients lose access to standard Medicare protections and treatments that could extend or improve life.
Dr. Oz says doctors are being paid to send patients to hospice inappropriately.
“They realized that they could pay doctors to move people into hospice,” Oz said. “The hospice is designed for the last six months of your life. It means you’re going to die. These hospice programs are created when the most common reason that you’d enter it is cancer. But these days, not everyone with cancer dies, but also you’re putting a lot of people with Alzheimer’s and other conditions in there. So it became a little harder to police.”
“But what happens if 100 percent of the people in hospice survive six months?” Oz asked. “Like, nobody dies.”
Medicare has clear checkpoints to try to prevent misclassification: new hospice patients face an evaluation at 90 days and again at 180 days, then certification reviews every six months thereafter. Average hospice stays reported by Medicare are about 92 days, so wildly long or unusually short patterns can signal trouble. When review processes are skipped or gamed, the program becomes vulnerable to exploitation.
“Doctors are being paid to send people in appropriately into hospice. Now that’s a problem…because if you’re put into hospice, you actually give up the rest of your healthcare protection. You no longer get traditional Medicare benefits because you’re in hospice, you’re dying,” Oz continued, “so we’re not going to pay all these extra expenses for things that aren’t going to benefit you, because you’ve decided to pull back. Voluntarily, you decided that you’re not going to go out there and try to get everything done for you, possible to help you live longer. You’ve made peace with the end.”
“But people are put on hospice who don’t know it, they don’t realize it,” Oz said. “And so now they don’t have access to regular Medicare anymore, so people are dying because they can’t get care because they were falsely tricked into being on hospice.”
“That’s a major concern for me, but then I began to look into how this could possibly happen,” Oz went on. “How is it that we’ve gotten seven times more hospice in California over the last several years? Do we have seven times more people dying? What’s going on here? And we began to realize it’s systemic fraud. Everyone decided not to do anything about this. We’re not going to look at it; it’s too painful, too difficult. Maybe some groups may benefit financially from not checking into this. The doctors are getting engaged so much in hospice that it’s beginning to undermine basic ethos of the healthcare profession.”
Dr. Oz said the fraud is “more rampant in California than you can imagine” and estimates billions of tax dollars are lost to fraud.
That money doesn’t disappear into a ledger; it removes services and options from seniors and sick patients who count on Medicare for care. State oversight and federal enforcement both need to spot payment patterns, audit suspicious referrals, and protect patients who may not know what has been signed on their behalf. The core problem is a system that allows financial incentives to override medical judgment and patient consent, and that has to be fixed without delay.
