Monday, August 31, 2026

Medicare Fraud Guilty Plea

 8/27/26 KTLA:

An Anaheim woman pleaded guilty Thursday to submitting more than $2.2 million in fraudulent Medicare claims for hospice care for patients who were not terminally ill, federal prosecutors announced.

Lynn Galbraith, 60, pleaded guilty to one count of health care fraud, according to the U.S. Attorney’s Office for the Central District of California.

Galbraith was the co-owner and operator of Garden Grove-based Azure Hospice Care Inc. from September 2019 until July 2022, when she became its sole owner. She remained the owner until February 2024.

During that time, prosecutors said Galbraith knowingly submitted claims to Medicare for hospice services provided to patients who did not have a terminal illness with a life expectancy of six months or less, as required to qualify for the benefit.

According to her plea agreement, Galbraith either knew the patients did not qualify for hospice care or knew there were insufficient medical records to support diagnoses and prognoses that would make them eligible.

Prosecutors said she also did not routinely coordinate with patients’ primary care physicians about their purported conditions or terminal prognoses.

In one example cited by federal officials, Galbraith submitted a $6,600 Medicare claim in October 2022 for hospice services provided to a patient despite knowing there was insufficient medical documentation to establish that the person was eligible for hospice care.

Can we balance the budget. Sure "A million here, a million there, after a while it adds up to real money." And put off the inevitable bankruptcy of Medicare. 

4/16/26 U.S. Attorney's press release:

SAN DIEGO – Former teacher Jeanett Valenzuela Ayub pleaded guilty in federal court today, admitting that she conspired with others to launder millions of dollars of health care fraud proceeds.

In total, Valenzuela admitted that she and her co-conspirators billed Medicare nearly $51 million for bogus prescriptions and were paid approximately $20 million, ultimately laundering at least $14 million dollars of Medicare proceeds and paying $3.7 million in unlawful kickbacks.

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division. The core mission of the Fraud Division is to zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars.  Department of Justice efforts to combat fraud support President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs

According to her plea agreement, Valenzuela and co-conspirators owned and operated multiple durable medical equipment (DME) companies, which sold orthotics – including back, wrist, and knee braces – to Medicare beneficiaries.

Valenzuela admitted that in operating the DME companies, she and co-conspirators paid unlawful kickback payments to sham marketing companies who provided bogus prescriptions for DME. The prescriptions were signed by physicians who had no legitimate doctor-patient relationship with the beneficiary; had not conducted a legitimate medical evaluation of the beneficiary; and had not impartially determined that the beneficiary actually needed the DME.

 

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