DOJ Arrests Two for $4.8M Medicare Hospice Fraud Scheme in California

The U.S. Department of Justice announced the arrest of two West Covina women in a Medicare fraud scheme involving $4.8 million in false hospice care claims.

Normita Sierra, owner of two hospices in West Covina, Golden Meadows Hospice Inc. and D'Alexandria Hospice Inc., alongside her alleged accomplice Rowena Elegado, are accused of billing Medicare for hospice services provided to patients who were not terminally ill. Between September 2018 and October 2022, the pair reportedly received over $3.8 million from Medicare through fraudulent claims.

Sierra faces multiple counts, including healthcare fraud and conspiracy, while Elegado faces charges related to conspiracy and illegal remuneration for healthcare referrals. The scheme allegedly involved paying marketers to recruit patients who were not referred by primary care physicians, leading to extended hospice stays without genuine terminal diagnoses.

Additional individuals connected to the fraud have pleaded guilty to related charges of kickbacks and falsifying patient conditions. The case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General and the FBI. Convictions could result in substantial federal prison sentences for those involved. This case highlights ongoing regulatory challenges in hospice care billing, emphasizing the need for enhanced oversight to prevent Medicare fraud and protect program integrity.