By Better Family Legacy Insurance | Licensed in Georgia, Texas, Alabama, Arkansas, South Carolina, Louisiana, and 30+ additional states

When someone in your family is seriously ill, there are already enough decisions to make. You may be talking with doctors, managing appointments, or trying to understand what kind of care your loved one needs.

The last thing you want is confusion about what you are agreeing to.

That is why a recent federal healthcare fraud announcement caught my attention.

On October 22, 2026, the U.S. Department of Justice announced criminal charges involving several alleged healthcare fraud schemes in California. Three of those schemes involved more than $138 million in allegedly improper Medicare hospice claims.

According to federal prosecutors, some people were enrolled in hospice even though they were not terminally ill. Some reportedly did not even know they had been enrolled.

These are allegations. The criminal cases have not established that every person charged is guilty.

However, the announcement raises an important question for Medicare beneficiaries and their families.

Do you understand what it means to choose hospice care, and do you know what you are signing?

First, Let's Understand What Hospice Care Is

Hospice is an important Medicare benefit.

It provides comfort and support for people with terminal illnesses. Rather than focusing on curing the illness, hospice care focuses on managing pain, easing symptoms, and helping the person live as comfortably as possible.

Hospice may include nursing care, medications for symptom relief, medical equipment, counseling, and support for family caregivers.

It is not the same as ordinary home healthcare.

Someone receiving home healthcare may be recovering from surgery, receiving therapy, or managing an illness. Hospice is specifically intended for people who meet Medicare's terminal-illness requirements.

And choosing hospice does not mean that a person is being abandoned or that every type of medical care must stop.

Who Qualifies for Medicare Hospice?

Medicare Part A generally covers hospice care when the person meets the requirements.

A doctor must certify that the person is terminally ill, meaning their life expectancy is six months or less if the illness follows its normal course.

The person must also choose comfort-focused care instead of treatment intended to cure the terminal illness and related conditions.

There is something else families should understand.

The six-month requirement does not mean someone automatically loses hospice care after six months.

A person can continue receiving hospice care beyond that time if they still qualify and the required medical recertifications are completed.

This is one reason families should ask questions instead of making assumptions.

The Paperwork Matters More Than You May Realize

Before hospice care begins, a person must properly elect the Medicare hospice benefit.

That includes a document called the Hospice Election Statement.

This document identifies the hospice provider and explains important information about the decision, including when hospice services will begin.

The beneficiary must sign the required statement, or a legally authorized representative must complete it when permitted.

This is not just another routine form.

Choosing hospice affects how Medicare pays for certain medical treatments.

Before signing, I would want to know exactly what is changing, which doctor recommended hospice, and who will be responsible for providing the care.

I would also want a copy of everything I signed.

Families should never feel embarrassed about asking someone to explain a medical document in plain language.

Does Choosing Hospice Mean All Medical Care Stops?

No. And this is one of the most important things to understand.

When someone elects hospice, Medicare generally stops paying separately for treatment intended to cure the terminal illness and related conditions.

Instead, the hospice benefit covers appropriate comfort-focused care for those conditions.

However, Medicare can still cover medically necessary treatment for health problems that are unrelated to the terminal illness, subject to the applicable rules.

For example, someone receiving hospice care may also have another medical condition that requires attention.

The important question is whether the treatment is related to the terminal illness and how Medicare will cover it.

If you are unsure, ask the hospice team and the treating doctor before scheduling treatment.

You can also ask the hospice for a written explanation of services or medications it considers unrelated to the terminal illness.

What Did Federal Prosecutors Say Happened?

The October 22 Justice Department announcement described several alleged hospice fraud operations in California.

According to prosecutors, some organizations submitted Medicare claims for people who were not terminally ill.

In one alleged operation, marketers approached older adults at community centers with offers of free medical services. Prosecutors said hospice enrollment was not always explained to the people being recruited.

Other allegations involved false medical certifications, services that were not provided, and claims submitted for people who reportedly had not chosen hospice.

Some beneficiaries allegedly learned about their hospice enrollment only after Medicare or their regular healthcare providers contacted them.

Think about what that could mean for someone who is still receiving regular medical treatment.

They might discover an unfamiliar hospice provider on their Medicare record or experience problems with care that should never have been interrupted.

Again, these are allegations in federal criminal proceedings. They are not a reason to distrust every hospice organization.

Legitimate hospice care provides important support to many families.

The lesson here is to understand your choices and pay attention to your records.

Warning Signs Families Should Recognize

Not every unfamiliar charge is fraud. Sometimes a claim contains an error that needs to be corrected.

However, certain situations deserve a closer look.

• Be cautious if someone offers free medical services or gifts in exchange for your Medicare information.

• Ask questions if a representative wants you to sign paperwork without clearly explaining what it authorizes.

• Be especially careful if you see a hospice organization listed on your Medicare records and you never knowingly chose hospice care.

• Question medical services that Medicare says you received but that you do not remember receiving.

• Remember, someone being friendly or offering assistance does not automatically mean they represent Medicare. You have the right to know who is requesting your information and why.

How to Check Your Medicare Records

One of the simplest ways to protect yourself is to review your Medicare information.

If you have Original Medicare, you can sign in to your secure account at Medicare.gov and review processed claims.

You can also review your Medicare Summary Notice.

Look at the names of providers, dates of service, and services billed.

If you have a Medicare Advantage plan, review your plan's Explanation of Benefits and contact the plan about claims you do not recognize.

For hospice concerns, you can also contact Medicare directly to ask about the hospice election and related claims on your record.

If something does not look right, do not ignore it.

Write down the provider's name, the date, and what you are questioning.

Keep copies of any documents or notices you receive.

What If You Discover Hospice Enrollment You Never Authorized?

Start by contacting Medicare at 1-800-MEDICARE (1-800-633-4227).

Explain that you found a hospice enrollment or hospice-related claim that you do not recognize.

Ask Medicare to review the information and explain the appropriate steps to investigate and correct the record.

You should also contact your regular healthcare provider, especially if the situation is affecting medical treatment you still need.

If you believe your Medicare number has been misused, tell Medicare that as well.

Keep a record of the date you called, whom you spoke with, and what you were told.

You do not have to determine on your own whether a crime occurred before reporting something suspicious.

Before Choosing Hospice, Ask These Questions

If a doctor recommends hospice for you or someone you love, take time to understand the decision.

Here are questions worth asking:

• Why is hospice being recommended now?

• Which doctor certified that I qualify?

• What treatment will change if I choose hospice?

• What medical care can I continue receiving?

• Which hospice organization will provide my care?

• Is that organization approved by Medicare?

• What does the Hospice Election Statement mean?

• Can I change my mind later?

• Who should my family contact if there is a problem?

You may not need every answer at once, but you should understand the decision before the paperwork is completed.

And if you are helping an older parent or another family member, remember that being involved in their care does not automatically give you legal authority to make decisions for them.

Ask who is authorized to sign and what documentation is needed.

Georgia Families Have a Place to Ask for Help

For readers here in Georgia, the Georgia State Health Insurance Assistance Program, also called Georgia SHIP, offers free, unbiased Medicare counseling.

You can call 1-866-552-4464 and select option 4.

Georgia SHIP can help beneficiaries understand Medicare information and review notices.

For suspected Medicare fraud, contact Medicare directly at 1-800-MEDICARE.

The October 22 criminal announcement involved allegations centered in California. It does not mean that the same alleged operations have been identified in Georgia.

Still, the lessons about paperwork, Medicare information, and understanding healthcare decisions apply wherever you live.

Looking Ahead: Make Sure Your Family Understands the Decision

For me, this comes back to something I talk about often with Better Family Legacy.

Families need information they can understand before making important decisions.

Hospice can provide valuable comfort and support during a difficult time. When it is medically appropriate and properly chosen, it can make a real difference for both the person receiving care and the family helping them.

But that decision deserves a conversation.

Know why hospice is being recommended. Understand what changes. Read the paperwork. And keep track of your Medicare records.

Peace comes from knowing, not guessing.

This article is for general Medicare education and is not medical or legal advice. Hospice eligibility and treatment decisions depend on individual circumstances. Criminal charges discussed here are allegations unless proven in court. Better Family Legacy Insurance is not affiliated with Medicare or any government agency.

Sources

U.S. Department of Justice, October 22, 2026, Los Angeles Healthcare Fraud Takedown

Medicare.gov, Hospice Care Coverage

Medicare.gov, Reporting Medicare Fraud and Abuse

Medicare.gov, Checking the Status of a Claim

Georgia Department of Human Services, Georgia SHIP

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