Healthcare fraud enforcement in California—particularly involving Medicare, Medi-Cal, and hospice services—has intensified dramatically in recent years. Federal and state prosecutors are prioritizing these cases due to the enormous financial losses involved and the vulnerability of the patient populations affected. For providers, billers, and owners, the consequences of an investigation can be life-altering.
Understanding Medicare and Medi-Cal Fraud
Medicare (a federal program) and Medi-Cal (California’s Medicaid program) are both frequent targets of fraud investigations. These cases typically arise under statutes such as the federal False Claims Act, healthcare fraud statutes (18 U.S.C. § 1347), and California Penal Code provisions relating to insurance fraud.


