The building was unremarkable, a single-story stucco structure lost among the bustle of a Los Angeles street. It could have been an apartment, an office, a small shop – indistinguishable from its neighbors. But the door, a heavy slab of dark oak reinforced with a small security grill, hinted at something hidden within.
“Is Dr. Faustina here?” I inquired, presenting his name as verified with the medical board. The response, delivered through the grill’s small opening, was blunt: “He doesn’t work here.” A strange answer, considering federal records indicated over $40 million in Medicare billings attributed to the 87-year-old doctor’s number, all originating from addresses like this one.
Los Angeles has become a hotbed for healthcare fraud, a staggering loss for taxpayers estimated at $3.5 billion. Lawmakers are now demanding stricter oversight, uncovering a system where patients receive inadequate or nonexistent care, and doctors sign off on treatments without ever meeting their patients.
The scheme, as explained by home healthcare expert Dr. Ira Byock, relies on a deceptive shell game. Multiple agencies operate from the same address, using different names and licenses, deliberately keeping patient numbers low to avoid scrutiny. It’s not accidental; it’s a calculated strategy to evade detection.
California’s situation isn’t isolated, but its scale is unprecedented. The fraud involves phantom patients, shell companies, and even offshore owners, all converging on Los Angeles County. Remarkably, the county hosts 1,923 hospice providers – more than 36 states combined, and a staggering 33 times the number found in Florida or New York.
“Eighteen percent of the nation’s home healthcare billing originates in Los Angeles County,” stated Dr. Mehmet Oz, former head of the Centers for Medicare and Medicaid Services. “How is that even possible?” The sheer volume raised immediate red flags.
Congresswoman Claudia Tenney took notice, writing to Dr. Oz with alarming findings. Agencies linked to Dr. Faustina’s provider number billed Medicare nearly $600 million between 2021 and 2024, a 124% increase, with 95% of those payments concentrated in Los Angeles. Patient counts soared from 9,693 to 29,527.
Her investigation revealed a network of over 550 home health agencies and 250 hospices registered at the same addresses, including a notorious location in Van Nuys already flagged for fraudulent activity. The scale of the operation was breathtaking.
Documents supporting Tenney’s letter were shared with Dr. Gilbert Faustina himself, a physician who graduated medical school in 1963. Though residing primarily in Las Vegas, he agreed to a meeting in a nondescript Los Angeles apartment.
“Congresswoman Tenney claims your provider number has been used to bill Medicare $600 million, and you’re somehow responsible for 29,000 patients. How can that be?” I asked. His response was a simple, bewildered, “I don’t know them. I don’t do the billing. I’ve never billed Medicare for any of these patients.”
He admitted to receiving $3,000 a month from a home healthcare agency, but insisted he hadn’t actively treated patients in months, reviewing only “ten or fifteen charts” during a single weekly visit. Yet, federal records showed 76,000 claims filed under his name.
Dr. Faustina vehemently denied any association with hospice care, but records linked him to 18 providers. Visits to these supposed hospices revealed a disturbing reality: many were little more than mail drops, operating out of dilapidated or empty buildings. Doors remained unanswered, phone calls went to voicemail, and names had been stripped from the signage.
One address in Van Nuys housed over 100 hospice and home healthcare agencies, yet a thorough search of all three floors revealed not a single patient, family member, doctor, nurse, or administrator. The building lacked any external signage, requiring visitors to be buzzed in by the building manager.
An agency that briefly employed Dr. Faustina admitted to severing ties after learning Medicare had suspended his billing privileges. When asked if he believed someone was committing fraud using his identity, his answer was unequivocal: “Absolutely. Not on my behalf, on their behalf.”
