Dr. Oz Issues Stark Warning About Medicare Fraud

For millions of Americans, Medicare is a key component of their retirement plan, helping them afford the health care they need, including hospice services. When physicians see patients covered by Medicare, Medicare reimburses those physicians for the services provided, often covering up to 80% of the provider fee schedule amount, while the patient pays the 20% coinsurance.

But Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz has announced a stark warning to physicians after revoking Medicare authorization for one physician for committing alleged Medicare fraud. The case highlights concerns about whether physicians are actually performing the services they bill Medicare for, and how fraud affects the program and Medicare beneficiaries.

Alleged Medicare fraud in California

Dr. Oz announced that CMS has stripped Medicare authorization for Dr. Rajiv Bhura, a Los Angeles physician, with significant and questionable Medicare hospice charges. In 2024 alone, Dr. Bhura was listed on Medicare reimbursements for at least 2,800 patients totaling $71 million. Those patients spanned 126 California hospices, leading to questions on an auditors' report about how one physician could possibly see so many patients in a single year.

California auditors noted that a physician working with more than three hospice providers could be a warning sign, so the 126 providers in this case set off red flags.

Addressing Medicare fraud

Dr. Oz spoke out against Dr. Bura's actions, using the revocation of his Medicare authorization as a warning to other providers. "To all the fraudsters out there stealing from our seniors: run, don't walk. Because we're coming after you," Dr. Oz posted on social media.

When CMS revokes Medicare privileges, the physician is effectively prohibited from receiving Medicare reimbursement payments. According to CMS data for December 2025, the latest available, 69.9 million people were enrolled in Medicare. Barring a physician from the program that serves such a large portion of the population can have a significant effect on their business.

The prevalence of Medicare fraud

This case is just one instance of Medicare fraud. The Arizona Department of Economic Security reports that Medicare fraud, errors, and abuse cause annual losses of approximately $60 billion.

In late March and early April, a task force led by Vice President JD Vance suspended 221 health care providers in Los Angeles for suspected Medicare fraud. Several providers were raided by federal authorities.

Why hospice services have drawn regulatory scrutiny

Hospice services have recently drawn increased attention. According to the Office of Inspector General, approximately 1.8 million Medicare beneficiaries receive hospice services annually, and Medicare pays about $27.5 billion for that hospice care.

Issues like poor quality of care, limited transparency for patients and their families, and the rapid growth of new hospices have prompted increased regulatory oversight. Fraud schemes that involve hospice providers enrolling beneficiaries without their consent have occurred, and inappropriate billing practices are a concern. As a result, increased oversight and new policies are being proposed as the government takes a harder look at hospice.

Proposed measures for increased hospice oversight

On April 2, CMS announced a new, proposed hospice scoring system to help combat fraud. The scoring system would evaluate factors like inappropriate Medicare utilization, quality of care, and compliance concerns. The system would help ensure that Medicare hospice benefits aren't abused and that hospice facilities provide appropriate care to beneficiaries. It would allow legitimate hospices to thrive and would support those high-quality providers.

How Medicare fraud harms beneficiaries

Medicare fraud not only affects the program but also impacts Medicare beneficiaries. When practices commit fraud by intentionally billing Medicare for services that weren't necessary or weren't provided, the program's expenses increase. As fraud increases Medicare billing, the program has less funding to improve coverage for beneficiaries.

Beneficiaries may face higher premiums, deductibles, and copayments if their medical provider commits Medicare fraud. It's also possible that beneficiaries will need to pay copayments for medical services that they didn't need or receive. In some cases, a provider committing Medicare fraud may add an inaccurate diagnosis to a beneficiary's medical records, resulting in inaccurate records and potentially complicating future care.

Looking for and stopping Medicare fraud

The Dr. Bhura Medicare case is part of a broader active federal crackdown on Medicare fraud. That fraud doesn't just waste federal dollars, but can also compromise the quality of care that patients receive. Any deliberate health care fraud is terrible, but involving hospice services, which are intended to support patients and their family members during an incredibly difficult time in their lives, is particularly egregious.

That's why the government is taking an active stance and working to identify and stop fraud.

Bottom line

Unfortunately, Medicare fraud does occur, especially in hospice settings. The public nature of the recent California health care provider suspensions and the revocation of Dr. Bhura's Medicare authorization might set an example and a warning to other health care providers, helping protect these important senior benefits for Medicare enrollees who depend on them.

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