A 46-year old woman, Sharon P., from Placentia, Calif. was sentenced for running a hospice that submitted millions of dollars in fraudulent bills to Medicare and Medi-Cal. The Medi-Cal and Medicare scam involved the submission of claims for patients for end-of-life care who were not really dying.

U.S. District Judge S. James O. presided over the felony health care fraud case in October 2015.  Sharon pleaded guilty to the charges. Her mother, Priscilla V., was also involved in the $8.8 million Medicare scam. She is serving eight years in prison for her involvement.

According to MyNewsLA, Los Angeles-based prosecutors are asking the judge to mandate a payment of $7 million in restitution from Sharon and to sentence her to 27 months in federal prison for the Medi-Cal and Medicare scam.

Five other individuals were also involved in the Medi-Cal and Medicare scam. The charges of the five individuals, including the mother and daughter pair, were brought in 2015, with 25 counts of money laundering and health care fraud. Each count of money laundering and health care fraud bears a possible multiple-year prison sentence.

Sharon’s mother, Priscilla, purchased the hospice facility based in Covina, Calif. in late 2007. She purchased the hospice care facility while under investigation for a prior case. Priscilla recently completed a 4 ½ year federal prison sentence in Victorville for a separate fraud scheme. She also faced felony health care fraud counts before the judge and pleaded guilty in December.

California Hospice, run by Sharon, reportedly submitted nearly $9 million dollars in fraudulent bills to Medicare and Medi-Cal between March 2009 and June 2013. According to the lawsuit, the facility submitted claims for patients for end-of-life care, even though the patients were actually doing fine.

Public health programs also helped with end-of-life care and paid $7.5 million for false and fraudulent bills. According to MyNewsLA, as part of the Medi-Cal and Medicare scheme, Sharon and her mother paid “marketers” or “cappers” to recruit and bring in beneficiaries to the hospice facility.

With new incoming beneficiaries, other individuals involved in the Medi-Cal and Medicare scheme, such as a registered nurse, would perform “assessments” to determine if a patient required end-of-life care and if they were terminally ill.  Regardless of whether the patients were or were not terminally ill, a doctor at the hospice facility would certify the patient was dying.

The hospice facility would also allegedly modify patient’s medical records to make them look more terminally ill to bypass Medicare audits. End-of-life care for beneficiaries of the hospice facility were paid millions of dollars by Medi-Cal and Medicare through the scheme.

Often Medicare scams are uncovered by employees within the company who then report the crimes to the government.  The government often rewards whistleblowers who help bring down Medicare fraud schemes.