Choosing care for someone you love is one of the harder decisions a family makes, and it usually happens under pressure — after a hospital stay, a difficult diagnosis, or a phone call you didn’t expect. That’s exactly why a recent piece from CaringInfo, a program of the National Alliance for Care at Home, is worth your time. It walks through how hospice and home care fraud actually works, and what families can watch for.
We want to say the most important part first: this is not the norm. As the CaringInfo team puts it, “fraud remains far from common or widespread across the field.” The overwhelming majority of hospice and home health care in this country is delivered by nurses, aides, social workers, and chaplains who take the work seriously. But the small number of bad actors do real damage — not only to the families they target, but to the trust every family needs in order to say yes to care at home.
What fraud in home-based care looks like
Health care fraud happens when someone exploits Medicare or Medicaid for financial gain. In the home-based care space, that can mean billing for visits that never happened, enrolling people who aren’t eligible for hospice, or signing someone up for services they never agreed to. CaringInfo notes that these schemes tend to cluster in a handful of geographic hot spots rather than appearing evenly across the country, and that federal regulators are actively pursuing them.
Warning signs worth knowing
CaringInfo outlines several red flags. Among them:
- You’re being enrolled in hospice or home health without a real conversation with a physician about whether you qualify.
- Someone offers gifts, free services, or other incentives in exchange for signing up.
- A stranger asks for your Medicare number, Social Security number, or other personal information by phone, text, or at your front door.
- The visits and services in your care plan aren’t happening — missed appointments, unreturned calls, or care that feels rushed.
- You receive a bill for something you don’t remember receiving.
If something feels off, you are not stuck. You have the right to ask questions, to understand what your care will cost, and to change providers.
What legitimate care at home should feel like
One of the best defenses is simply knowing what good care looks like:
Hospice care brings a full team to you — typically a nurse, home health aide, social worker, and chaplain — with a nurse available around the clock. Medications, equipment, and supplies related to the hospice diagnosis are provided as part of the benefit.
Home health care means scheduled clinical visits from a nurse or therapist to check vitals, manage wounds, or guide therapy, with needed equipment arranged through the agency as part of your plan of care.
Private care is non-medical support with daily life — bathing, dressing, meals, errands — for a set number of hours. It’s paid privately or through long-term care insurance rather than Medicare.
How to vet a provider before you commit
A few practical questions to ask any agency:
- Is the agency Medicare-certified, and how long has it operated in this community?
- Who will actually be coming to the house, and how often?
- Who do I call at 2 a.m.?
- What is covered, and what will I be billed for?
- Can you put the plan of care in writing?
Any provider worth hiring will welcome those questions.
Where VNA fits
VNA has cared for North Texas families for generations as a nonprofit organization. That structure matters here: our obligation runs to our patients and our community, not to shareholders. Our hospice team, our palliative care team, and our private care caregivers work under the same mission — to provide care to our community, enhancing health and wellbeing with compassion, dignity and integrity.
If you’re weighing care options for yourself or someone you love, we’re glad to talk it through, even if you ultimately choose another provider. Call us at (214) 689-0000 or contact us here.
Read the full CaringInfo article: Hospice & Home Care Fraud: Know the Signs
This post summarizes and comments on reporting published by CaringInfo, a program of the National Alliance for Care at Home. The original article is also available in Spanish.