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WASHINGTON, D.C. – In case you missed it, the Orrin G. Hatch Foundation’s 2025 Hatch Center Policy Review featured an essay by Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, titled Dominance, Deployment, and Safeguards: The Path for American AI Leadership.

In the essay, Chairman Guthrie warns that America risks falling behind China in artificial intelligence and outlines a strategy to strengthen U.S. innovation, secure supply chains, and expand global leadership.

In Case You Missed It:

“One of the defining traits of the American experiment has been a commitment to exploring the unknown. From the early explorers who first landed in the Americas to the modern technology industry that has placed a powerful computer in the pocket of every American, we are a nation of trailblazers.

“What makes this moment unique is the pending threat to America’s leadership in artificial intelligence (AI) technology by the People’s Republic of China (PRC) and Chinese Communist Party (CCP)–backed companies, many of which have developed advanced technologies nearly at parity with that of American AI companies. Knowing that the AI revolution will define economic growth and global competitiveness for the next century, the United States must choose to innovate.

“The stakes couldn’t be higher. China already deploys next-generation technologies to advance many of the regime’s most sinister goals focused on enhancing the power of its Orwellian surveillance state utilizing advanced computing. Even more concerning to the American public is the threat of an adversary’s technology stack serving as the building blocks for future advancements or as a strategic chokehold. For example, we have unfortunately learned this lesson the hard way through Chinese bottlenecks related to telecommunications equipment and critical mineral mining and processing.

“Strengthening our supply chains is an area where Republicans and Democrats largely agree. Even the Biden Administration took dramatic action to address national security risks from autonomous and connected vehicles to prevent cars and trucks built by CCP-aligned manufacturers from operating in the United States.

“President Trump has also been crystal clear: American supply chains can no longer rely on our adversaries’ goodwill. China will use any economic and technological leverage over Americans and the products we use if given the opportunity. The ongoing threat of China doesn’t just call for an agenda that restricts the aggression of the PRC, but also an agenda that promotes American innovation at home and abroad.

“At the House Committee on Energy and Commerce, we have three pillars that guide our approach to AI: dominance, deployment, and safeguards.

“For the United States to be dominant in AI, we must be the ones to actually develop and deploy these new technologies at scale. When I talk with business leaders, they tell me we have the brainpower and the capital necessary to compete. However, we still need to increase our energy production to meet rising electricity demand, and we need to ensure our regulatory environment is structured to meet this moment.

“China has chosen the path of top-down government control to drive its AI industry. While this strategy affords the CCP some advantages, the American model of bottom-up, free-market capitalism has long been the engine of innovation for the world, and it is more efficient in the long run.

“Unfortunately, our allies across the Atlantic have taken the opposite approach and made the mistake of racing to heavily regulate technologies, slowing innovation as a result. Onerous, conflicting, and confusing regulations are suffocating European technology companies and effectively grounding the AI industry there before it can even get off the ground.

“And to those who recommend America follow that path, I would remind you: We are not in a race with Europe to regulate. We are in a race with China to innovate.

“A patchwork of state laws here at home would have the same effect, stalling AI development and deployment and providing our adversaries with opportunity to advance, excluding Americans from the benefits of a new technological revolution founded on fundamentally Western values. It is vitally important for American technology companies to be the ones setting global technology standards for the next generation of tools and systems.

“President Trump’s AI Action Plan includes a range of policies to put us back on track to export a full American stack of AI products and services to our allies. Prioritizing the export of American products and services helps embed American-driven technical standards in global markets, expand our economic influence, and strengthen our national security.

“But maintaining global leadership cannot occur without deploying energy and broadband infrastructure at scale. By consuming enormous amounts of electricity to power vast networks of computers, AI data centers effectively convert energy into intelligence, and at a scale we’ve never seen before.

“The U.S. is blessed with an abundant supply of natural resources that can be leveraged to generate the baseload, dispatchable electricity necessary to power data centers, broader electrification efforts, and advanced manufacturing. But we need the right approach at the federal level to seize this moment, and building the energy infrastructure to power the future is the first step.

“But we also need to look at the broad application of AI technologies and the promise of benefits for consumers that span our entire economy. This year the Committee has already held hearings across our wide jurisdiction demonstrating the ways AI can improve the everyday lives of Americans.

“For example, AI technologies can help to limit the frequency and duration of network blackouts, meaning better coverage in cases of emergencies or cyberattacks. After an expansive operation to cripple telecommunications in New York City was linked to China this fall, this could mean the difference between life and death.

“Autonomous vehicles are on track to have the same effect. The National Safety Council estimated that Advanced Driver Assistance Systems could save hundreds of thousands of lives in the coming decades. Even setting aside the radical improvements in safety, AI-supported vehicles will offer elderly Americans and people with disabilities new options for independence.

“In health care, AI can expedite the repetitive, administrative processes that slow treatment and research, freeing providers to focus on their core skills treating patients. Supporting—not replacing—health care professionals has long been a critical priority for Congress, and artificial intelligence may represent a generational opportunity to advance those efforts.

“You may see a theme emerging: AI can make the world safer and workers more productive. But with that goal in mind, we also recognize the need for narrowly tailored protections to address new and unexpected harms. The TAKE IT DOWN Act—which was signed into law earlier this year—is a perfect example of Congress’s ability to provide guardrails where existing law does not suffice. Bipartisan majorities in Congress worked closely with the President and First Lady Melania Trump to target the spread of sexually exploitative, non-consensual AI images, filling gaps in the law related to emerging technologies.

“With AI advancements continuing to permeate the digital economy, American families deserve tools as sophisticated as the platforms their kids are using. Modern challenges require modern protections, which is why the Energy and Commerce Committee is also working to make the internet safer for kids as AI technologies increasingly shape online experiences.

“Similarly, Americans of all ages should be entitled to commonsense data privacy protections, especially in the era of large language models that use vast amounts of data to train AI algorithms. Passing one national, comprehensive data privacy bill—so your privacy protections do not change crossing state lines—would be a critical step toward restoring trust online, without unduly hurting American entrepreneurs.

“Artificial intelligence is already helping raise the tide so every American can benefit. Continuing that momentum requires commitments and intentional decisions by the leaders of industry, government, and civil society. Challenges will inevitably arise, but that has never stopped our nation from innovating, creating, and growing before.

“The rest of this century will either belong to the United States and its allies or China. If we cede the technological edge, we risk losing our ability to expand our influence abroad and will provide a platform for China to expand its authoritarian state and stifle human freedom.

“The strong U.S. economy and our workers are the greatest assets we have. As long as we choose to embrace those strengths instead of holding ourselves back, America will continue to succeed. Our leadership has undoubtedly made the world stronger and more prosperous in recent decades, and we don’t plan on stopping now.”

WASHINGTON, D.C.– Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, announced a hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid.

“The goal of this hearing is to understand current trends in fraud schemes targeting Medicare and Medicaid nationwide—how taxpayer dollars are being wasted, how beneficiaries are affected, and how transnational crime organizations are increasingly involved—and explore ways to better prevent and detect fraud,” said Chairmen Guthrie and Joyce. “As fraud schemes are being perpetrated across the United States, it’s important we recognize that we cannot preserve our Medicare and Medicaid programs for our most vulnerable if we don’t combat destructive fraud that is draining the system. We applaud actions that the Trump Administration has already taken to address these schemes, and we look forward to continuing to explore, and implement, solutions that root out fraud in our government health programs.”

Subcommittee on Oversight and Investigations hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid.

WHAT: Subcommittee on Oversight and Investigations hearing on how fraudsters are draining state and federal governments through fraud in our government-run health programs.

DATE: Tuesday, February 3, 2026

TIME: 10:30 AM ET

LOCATION: 2360 Rayburn House Office Building

This notice is at the direction of the Chairman. This hearing will be open to the public and press and will be livestreamed at ** energycommerce.house.gov **. If you have any questions about this hearing, please contact Annabelle Huffman with the Committee staff at ** Annabelle.Huffman@mail.house.gov **. If you have any press-related questions, please contact Katie West at ** Katie.West@mail.house.gov **.

WASHINGTON, D.C.– Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, delivered the following opening statement at today’s hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability.

Subcommittee Chairman Griffith’s opening statement as prepared for delivery:

“Today we will discuss health care costs and patient access challenges by examining affordability across the entire health insurance marketplace.

“This hearing builds on work Republicans have done this Congress to address health care affordability.

“We plan to have future hearings with other leaders and experts across the health care continuum to understand the root causes of rising health care costs.

“Specifically, this hearing will focus on the role insurers play in the delivery of care.

“The insurance market is dominated by a handful of Fortune 50 corporations that control the majority of the national market.

“In some states, a single insurer may even control 80 or 90 percent of a particular market.

“The biggest health insurers today often manage several facets of the health care supply chain, such as owning the pharmacy benefit managers; the group purchasing organizations; multiple provider groups; and specialty or mail-order pharmacies.

“Even with owning those, complicated benefit designs, narrow networks, prior authorization requirements, and opaque coverage decisions often leave patients feeling like they are paying more for less.

“The market also lacks transparency and is not easily navigable.

“One contributor to health insurance unaffordability for millions of Americans is the so called ‘Affordable Care Act,’ also known as Obamacare, that was signed into law in 2010.

“When Democrats passed Obamacare, without Republican support, they sold the bill on the promises that premiums would fall, competition would rise, and ‘if you like your insurance plan, you will keep it.’

“Instead, Obamacare has increased health care costs, warped incentives, federalized benefits, restricted plan design, and limited access to care.

“Many patients have fewer plan choices than they did before Obamacare was enacted. In fact, a constituent told me recently that his family only has one provider option. Therefore, Obamacare coverage is not translating to patient or taxpayer affordability.

“Unfortunately, employer-sponsored insurance is also becoming unaffordable, and, each year, more American small businesses choose not to offer health insurance because it is too costly.

“This impacts the ability for a small business to be competitive and attract talent.

“We know two things are true:

“Competition is essential for patient access! Lack of competition and consolidation within the insurance marketplace has led us to higher health care costs as a whole.

“The health care system needs to work for patients.

“That means empowering individuals with real choices, transparent prices, and coverage that fits their needs.

“We must strive to have more competitive plan options that reward quality and focus on affordability, access, and outcomes.

“Our discussion today is meant to move beyond politics and spur debate about how we can work toward delivering meaningful, innovative solutions for the Americans that we serve.

“We owe it to patients to get to the root causes of the challenges we see across the health sector, and I look forward to hearing from our witnesses.”

WASHINGTON, D.C. – Today, Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, led a hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability, featuring witness testimony from the biggest health insurance plan CEOs in the United States. During the hearing, Committee Republicans held health insurance plans accountable in their role of increasing health care affordability challenges impacting all Americans and discuss how Democrat policy failures in Washington D.C. have warped the American health care system and hurt patients access to high-quality health coverage options.

“Many patients have fewer plan choices than they did before Obamacare was enacted. Therefore, Obamacare coverage is not translating to patient or taxpayer affordability,” said Chairman Griffith. “We owe it to patients to have a health system that offers real choices, transparent prices, and coverage that fits their needs, and I look forward to seeing how today’s conversation presents solutions to make health care more affordable for all Americans.”

Watch the full hearing ** here **.

Below are key excerpts from today’s hearing:

Congressman Brett Guthrie (KY-02): “Experts, including the Congressional Budget Office, estimated that the expiration of the temporary Obamacare enhanced COVID Credit is projected to increase premiums by anywhere from 4 percent and 8 percent, depending on the market. Yet, many areas for 2026, insurers requested and were approved for premium increases of 30 percent, 40 percent, even 50 percent. So, Mrs. Boudreaux, you’re in Kentucky. The average Elevance Obamacare plan increased its premium by roughly 24 percent. Despite what Democrats would have the American people believe, the temporary COVID Credit does little to actually lower underlying Obamacare premiums and the American taxpayers are footing the bill. So, Mrs. Boudreaux, by your best estimation—even if the Democrats’ temporary COVID Credits were extended—would Obamacare plan bids in my state of Kentucky increase or decrease between 2026 and 2025?” Mrs. Boudreaux: “Well, thank you very much for the question, Congressman. You know, as we’ve shared, premiums reflect the underlying costs...” Chairman Guthrie: “So, they would have increased, right?”

Congressman John Joyce, M.D. (PA-13): “Since the passage of the ACA, we have seen costs across all markets continue to increase. One of the key issues driving this is the medical loss ratio, or the MLR, that requires plans to spend either 80 percent or 85 percent of your premium dollars on health care expenses. The MLR created multiple perverse incentives for insurance companies to dramatically consolidate both vertically and horizontally. The companies that you lead today are not just involved in insurance. You own PBMs, you own specialty pharmacies, you own retail pharmacies, you own GPOs, you own physician groups and practices. In some cases, you own hospitals, and you own drug manufacturing companies. And at least one of you owns a bank! This has led to alleged cases of self-dealing, as your companies work to circumvent the [multi-level marketing] requirements.”

Congresswoman Mariannette Miller-Meeks (IA-01): “The largest PBMs—CVS Caremark, Express Scripts, and Optum—have created rebate contracting entities, or PBM group purchasing organizations, which are adding to the complex and opaque nature of the medicine supply chain. My first PBM reform bill on transparency was in 2019, as an Iowa state senator. PBMs claim these entities provide them and their clients with greater bargaining power to lower costs, but recent investigations by Members of Congress, industry experts, state attorneys general, and federal oversight agencies suggest the opposite may be true. We have a graph up here. Let’s start with the left. The drugmaker pays rebates directly to the PBMs and PBM GPOs to ensure their drugs are included on their health plan formularies—meaning the drugs are covered by insurance. Then, these PBMs and their PBM GPO subsidiaries collect the rebates, which they promise to pass through to their patients and health plans. Can any of you tell me what percentage of rebates are passed through to the patient, who is paying a higher drug cost because the rebates are added to the price of the drug?” Top Health Insurers: “...” Congresswoman Miller-Meeks: “Is it zero?” Top Health Insurers: “...” Congresswoman Miller-Meeks: “You don’t even know that you’re not giving these patients back a rebate for paying higher drug prices.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, are requesting communications, documents, and information from Minnesota Governor Tim Walz and the Temporary Commissioner of Minnesota’s Department of Human Services, Shireen Gandhi, to better understand the ongoing Medicaid fraud occurring in the state of Minnesota and actions the state is taking to strengthen program integrity.

The unprecedented fraud scheme in Minnesota, which has potentially been ** ongoing ** since 2013, has revealed a swath of criminal schemes, including overbilling, false records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, people struggling with addiction, and homelessness. Chairmen Guthrie, Joyce, and Griffith issued the following statement regarding ** the letter’s ** content:

“The extensive fraud schemes being perpetrated in Minnesota have wreaked havoc on government-funded health programs. We have an obligation to ensure finite taxpayer dollars are being used responsibly, and that the most vulnerable Americans are not being exploited to the benefit of fraudsters and foreign actors,” said Chairmen Guthrie, Joyce, and Griffith. “As members of Congress and this Committee, our track record has made our continued commitment to ridding government programs of waste, fraud, mismanagement, and abuse clear. This letter is the next step in the Committee’s work to root out fraud and restore program integrity in our federal health programs nationwide.”

The Trump Administration has taken concrete steps to address the fraud being uncovered in Minnesota. Complementary to that work, Congress has a responsibility to oversee federal programs, like Medicaid, to ensure precious dollars and resources are being spent appropriately to deliver quality and necessary care.

BACKGROUND:

Glaring accounts of waste, fraud, and abuse in Minnesota’s Medicaid social service and health programs have resulted in billions of taxpayer dollars going straight to the pockets of fraudsters and foreign actors.

• Ongoing investigations indicate that fraudulent provider schemes are particularly prevalent in health and community-based service programs, including residential drug and alcohol treatment, home health, housing, and autism service programs.

Unfortunately, Minnesota’s Medicaid program lacks adequate oversight and fraud control measures, and state officials have neglected to swiftly identify and address vulnerabilities in programs.

• Fraud experts note that fraudsters often target states like Minnesota, which tend to have the “weakest ID checks, fastest payouts, and lowest audit risk,” when looking to establish fraud schemes.

In July 2025, the Working Families Tax Cuts legislation was signed into law by President Trump, including critical provisions to target waste, fraud, and abuse within the Medicaid program—several of which help prevent the fraud schemes that occurred in Minnesota from happening again.

In response to these fraudulent practices, CMS is auditing the Minnesota Medicaid program, freezing provider enrollment, and deferring payments for 14 high-risk programs, including adult companion, rehabilitative mental health services, individualized home supports, residential treatment services, among others—which, alone, cost taxpayers $3.75 billion annually.

CMS recently briefed the Committee on what is currently known about the Medicaid fraud in Minnesota and actions CMS has taken to date. This further underscored the need for the Committee’s oversight to ensure program integrity.

WASHINGTON, D.C. – This week, the House Committee on Energy and Commerce is holding two Subcommittee Hearings and one Full Committee Markup. Read more below.

FULL COMMITTEE MARKUP: The Committee on Energy and Commerce will hold a markup of 11 bills.

• DATE: Wednesday, January 21, 2026
• TIME: 10:15 AM ET
• LOCATION: 2123 Rayburn House Office Building

SUBCOMMITTEE HEARING: The Energy and Commerce Subcommittee on Health is holding a hearing to have productive discussions with health insurance companies on the core drivers working against health care affordability—namely onerous government interference, administrative burdens, waste, fraud, and abuse, and lack of competition and patient choice.

• DATE: Thursday, January 22, 2026
• TIME: 9:45 AM ET
• LOCATION: 2123 Rayburn House Office Building

SUBCOMMITTEE HEARING: The Energy and Commerce Subcommittee on Environment is holding a hearing to discuss legislation to modernize America’s Chemical Safety Law.

• DATE: Thursday, January 22, 2026
• TIME: 2:00 PM ET
• LOCATION: 2123 Rayburn House Office Building

WASHINGTON, D.C. – The House Committee on Energy and Commerce will hold a Subcommittee on Health hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability. The hearing will feature testimony from top health insurance company CEOs and focus on the core drivers working against health care affordability.

WHAT: Subcommittee on Health hearing to have productive discussions with health insurance companies on the core drivers working against health care affordability—namely onerous government interference, administrative burdens, waste, fraud, and abuse, and lack of competition and patient choice.

DATE: Thursday, January 22, 2026

TIME: 9:45 AM ET

LOCATION: 2123 Rayburn House Office Building

Members of the media who wish to attend in-person should RSVP to their respective press gallery no later than 5:00 PM ET on Wednesday, January 21, 2026.

House Radio/TV Gallery:
** radiotv@mail.house.gov **
(202) 225-5214

House Periodical Gallery:
** Periodical.press@mail.house.gov **
(202) 225-2941

House Daily Press Gallery:
** dailypressgallery@mail.house.gov **
(202) 224-3945

Photographer Gallery:
** press_photo@saa.senate.gov **
(202) 224-6548

If you have any press-related questions, please contact Katie West at ** Katie.West@mail.house.gov **.

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, announced a hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability.

“Our constituents are feeling the effects of damage caused by Democrats’ failing health care policies, which have delivered worse health outcomes for patients by reducing choice and making care unaffordable and inaccessible. Now, they are doubling down, causing the rapid rise of health care costs,” said Chairmen Guthrie and Griffith. “Republicans have proposed many solutions to address this broken system, and this hearing is just the first step toward a larger effort to address the health care affordability crisis. We are working diligently to improve health outcomes and decrease the cost of care for all Americans.”

Subcommittee on Health hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability.

WHAT: Subcommittee on Health hearing to have productive discussions with health insurance companies on the core drivers working against health care affordability—namely onerous government interference, administrative burdens, waste, fraud, and abuse, and lack of competition and patient choice.

DATE: Thursday, January 22, 2026

TIME: 9:45 AM ET

LOCATION: 2123 Rayburn House Office Building

Members of the media who wish to attend in-person should RSVP to their respective press gallery no later than 5:00 PM ET on Wednesday, January 21, 2026.

House Radio/TV Gallery:
** radiotv@mail.house.gov **
(202) 225-5214

House Periodical Gallery:
** Periodical.press@mail.house.gov **
(202) 225-2941

House Daily Press Gallery:
** dailypressgallery@mail.house.gov **
(202) 224-3945

Photographer Gallery:
** press_photo@saa.senate.gov **
(202) 224-6548

This notice is at the direction of the Chairman. This hearing will be open to the public and press and will be livestreamed at ** energycommerce.house.gov **. If you have any questions about this hearing, please contact Annabelle Huffman with the Committee staff at ** Annabelle.Huffman@mail.house.gov **. If you have any press-related questions, please contact Katie West at ** Katie.West@mail.house.gov **.

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means, Congressman David Schweikert (AZ-01), Chairman of the Ways and Means Subcommittee on Oversight, and Congressman Vern Buchanan (FL-16), Chairman of the Ways and Means Subcommittee on Health, authored ** a letter ** to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) requesting a meeting on the concerning evidence detailed in the letter that points to large-scale, ongoing Medicare fraud in Los Angeles County, along with what action is being taken to address the situation.

“The House Committee on Energy and Commerce has an extensive history of digging deeper into matters where program integrity has been compromised. This letter is crucial in our commitment to eliminating waste, fraud, and abuse in federal health care programs,” said Chairmen Guthrie, Joyce, and Griffith. “Republicans have spent much of this Congress furthering legislation to protect our most vulnerable Americans—especially seniors, but our work is not done. Continued oversight is crucial to uphold the integrity of programs that serve our most vulnerable populations. We applaud the ongoing work being conducted by HHS-OIG in cracking down on the fraud that has occurred, and we look forward to addressing the larger-scale scheme that is draining public resources from Americans who need these services the most.”

“Medicare home health and hospice fraud directly undermines the safety and reliability of care for America’s most vulnerable seniors. Auditors have reported an unprecedented jump in home health and hospice fraud in Los Angeles County, California – including one report showing 112 different hospices located at the same physical address. With $1.2 billion in improper payments in home health claims and the Inspector General reporting $198 million in suspected hospice fraud, Gavin Newsom’s California could just as well be another Minnesota,” said Chairman Smith. “The Ways and Means Committee will not hesitate to use our broad oversight authority to get to the bottom of this and protect taxpayers and vulnerable patients against these bad actors.”

BACKGROUND:

Evidence has strongly suggested large-scale Medicare fraud involving home health agencies (HHA) and hospice agencies in Los Angeles County, California, noting that such practices not only drain public resources but also compromise the quality of care provided to patients, especially those most vulnerable populations.

• The Centers for Medicare and Medicaid Services (CMS) found that the 2023 improper payment error rate for home health claims was 7.7 percent, or about $1.2 billion, in 2023.
• In terms of hospice care, HHS OIG reported suspected hospice fraud to be an estimated $198.1 million in fiscal year (FY) 2023.
• CMS has placed HHAs as an area of high risk for Medicare fraud.

Emerging concerns over Medicare fraud in the HHAs and hospice sector highlights heightened activity, specifically in Los Angeles County.

• From 2019 through June 2023, HHAs in the U.S. decreased from 8,838 to 8,280 (6 percent), while, at the same time, HHAs in Los Angeles County increased from 896 to 1,309 (46 percent).
• More than 1,400 new Los Angeles County HHAs enrolled in Medicare in the last five years, representing over 50 percent of all HHAs in the state of California and nearly 14 percent of all HHAs in the country.

Based on data from the March 2022 California State Auditor’s Report and from HHS on hospice ownership, Los Angeles County had more than 31 percent of the hospice agencies in the U.S. in 2022.

• There were approximately 58 million seniors in the U.S. in 2022, with Los Angeles County having approximately 1.49 million seniors (2.5 percent).
• The report highlighted indicators that included a “rapid, disproportionate growth in the number of hospice agencies” and “excessive geographic clustering of hospice agencies,” noting that 112 different licensed hospice agencies were located at the same physical address.
• State auditors in California estimated that hospice agencies in Los Angeles County likely overbilled Medicare by $105 million in 2019.

These accounts of widespread fraud occurring in Los Angeles County’s HHAs and hospice agencies have raised concerns about whether home health and hospice Accrediting Organizations (AO) are effectively examining such organizations at the time of their enrollment in Medicare.

• In November 2024, CMS issued a Quality, Safety, and Oversight memo to surveyors, reminding them to closely inspect hospices’ Medicare enrollment documents to understand changes in ownership and location, but neglecting to encourage AOs to pursue other commonsense antifraud measures.

In April 2025, HHS OIG announced that the Office of Audit Services would compile a report for FY 2026 to identify trends, patterns, and comparisons that could indicate potential vulnerabilities related to new Medicare hospice provider enrollments.

In May 2025, the Health Care Fraud Strike Force—a joint task force of federal, state, and local law enforcement agencies, including HHS OIG—** announced multiple arrests ** following a multi-year investigation into Armenian Organized Crime, which dismantled five hospices in the greater Los Angeles area.

On November 28, 2025, CMS ** announced ** the Calendar Year 2026 Home Health Prospective Payment System Final Rule, providing comments that suggest an interest in addressing the aforementioned accounts of fraud.