87-year-old doctor’s Medicare number linked to $600M in fraud

The white, one-story stucco building on a busy, sandy street in suburban Los Angeles looked like any other. Among the apartments, offices, and sidewalk kiosks, the only defining feature was the building’s door; thick, solid dark oak slab and small, safety grille about fifteen inches square.

“Is Dr. Faustina here?” I asked. “This is his registered address with the medical board.”

The cutaway reads, “It doesn’t work here.” A face appeared that said:

According to federal records, multiple home health agencies at that address are home to 87-year-old Dr. I thought this was odd, considering Gilbert Faustina billed Medicare for more than $40 million using her Medicare number.

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But health care fraud is big business in Los Angeles, as multiple state and federal audits have shown, and taxpayer losses are estimated at $3.5 billion.

Lawmakers on Capitol Hill are demanding that federal investigators implement stronger oversight to combat what they call “large-scale fraud,” with patients receiving inappropriate or nonexistent care, doctors signing off on patient care plans without ever meeting the patient, and hospice and home health providers using multiple licenses to “shuffle” patients from one facility to another to evade state and federal inspections.

A national expert on home health care and the author of many books, Dr. Ira Byock explains how the shell game works.

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“You’ll have three, four or 10 of them operating out of one address, under different names and with different licenses, but they’re all serving only a few patients, which keeps them at a level that keeps them under the radar of Medicare’s criteria for serving hospice programs,” he said. “This is not a bug. This is a strategy bad actors use to avoid scrutiny.”

What’s happening in California is not unique, but its scope is. Ghost patients, fake companies, offshore owners and corrupt doctors. There are 1,923 hospice providers in Los Angeles County alone. That’s more than 36 states combined and 33 times more than Florida’s 58 or New York’s 40.

Director of the Centers for Medicare and Medicaid Services, Dr. “18 percent of the entire nation’s home health care bills come from Los Angeles County,” says Mehmet Oz. “How is this possible?”

Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services (CMS), questioned that nearly one-fifth of the nation’s home health care bills come from Los Angeles County. (Nikos DeGruccio/Fox News Digital)

The scam in Los Angeles was sparked by Dr. Oz, who wrote to Oz in November. It also caught the attention of New York Congresswoman Claudia Tenney, who called for an investigation into providers linked to Faustina’s 10-digit provider number.

“Between 2021 and 2024, home health agencies affiliated with this doctor in his 80s who lived outside California billed Medicare nearly $600 million, of which nearly $210 million in 2024 alone, a 124 percent increase from 2021, with 95 percent of these payments concentrated in Los Angeles County. Number of beneficiary patients in 2021 29,527 for these physician-affiliated home health agencies, up from 9,693 in 2021.”

“Additionally, a review of other home health and hospice programs registered at the same addresses as those affiliated with this physician shows that more than 550 home health agencies and more than 250 hospices are active on Medicare, including the infamous Van Nuys address, which has long been flagged by law enforcement for Medicare and Medicaid fraud.”

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Fox News obtained the source documents used to support Tenney’s letter and shared the records with Faustina, a bright and energetic physician who graduated from medical school in 1963. His primary residence is in Las Vegas, but he agreed to speak to us at an apartment in the Van Nuys neighborhood of Los Angeles.

“[Congresswoman] “Tenney claims that your national provider number was used to bill Medicare for $600 million and that you were somehow responsible for $29,000,” I asked. “How could this be?”

“I don’t know them (providers using the Medicare number),” Faustina said. “I don’t do the billing. I have never billed Medicare for any of these patients. I am paid $3,000 a month from this home health agency.”

“I’m not seeing anyone right now. I saw about ten or fifteen paintings when I went to visit last month, but that’s one day a week.”

The case also caught the attention of Rep. Claudia Tenney, RN.Y. (Anna Moneymaker/Getty Images)

But federal records show 76,000 claims were filed on behalf of thousands of patients. Records also link him to 18 hospice providers, which he denies.

“I have no affiliation with any nursing homes,” he said.

We visited many nursing homes using Faustina’s Medicare number. Many looked more like postal deliveries than medical offices. Many were in run-down or largely vacant buildings. No one answered the door and phone numbers went to voicemail. Some names had been removed from the frame in the lobby, but they were still billing Medicare at that address.

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There were more than 100 hospice or home health agencies at one address in Van Nuys, but I walked all three floors and did not see a single patient, family member, doctor, nurse, or administrator. There was no sign on the outside of the building indicating that a service provider was inside, and you had to ring the building manager’s bell to get in.

Elsewhere, Dr. An agency that hired Faustina part-time said it cut ties after learning Medicare had suspended its billing privileges.

“So, do you think someone is committing fraud in your name?” I asked Faustina.

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“Absolutely,” he said. “Not in my name, but in their name.”