A Southern California physician, Dr. Rajiv Bhuva, is linked to Medicare reimbursements for nearly 2,800 hospice patients across 126 providers in 2024 — about 20 times the state average — raising questions about oversight in the state's rapidly expanding hospice sector, according to a CBS News investigation published Tuesday.
The claims generated roughly $71.7 million in taxpayer-funded payments, placing him among the highest-billing hospice physicians in California.
Experts say such a workload would be extraordinarily difficult to manage.
"They would have a superhuman schedule to do that in a meaningful way," said Dr. Kristina Newport, chief medical officer at the American Academy of Hospice and Palliative Medicine.
Hospice physicians are required to conduct in-person evaluations and ongoing care reviews for terminally ill patients, responsibilities that industry leaders argue are incompatible with the volume of cases tied to Bhuva.
Data reviewed by CBS also found that fewer than 2% of those patients died in 2024, an unusually low rate in a field where patients are typically near the end of life.
Bhuva told CBS News that he doubted the figures and noted there is no legal cap on how many hospice patients a physician can serve, but he declined further comment.
The data does not establish whether he personally authorized the claims or whether his medical credentials were used improperly.
The investigation highlights concerns about fraud in California's expanding hospice sector.
State auditors have warned that physicians listed across multiple hospice providers, particularly more than three, may signal fraud.
More than 600 doctors in California exceed that threshold, accounting for more than half of the state's $4.2 billion in Medicare hospice reimbursements in 2024.
In some cases, auditors and advocates say physicians' identities may be misused.
"There are few legitimate explanations for a physician's name to appear on thousands of claims," state auditors previously reported, raising concerns that certifications may amount to little more than a rubber stamp.
Regulators have already taken action in similar cases.
Another California physician recently had her Medicare enrollment revoked amid concerns her provider identifier was used fraudulently. Several hospices tied to high-volume billing patterns have also lost Medicare certification for abusive billing practices.
The findings come amid increased federal scrutiny of hospice fraud, including efforts during the Trump administration to crack down on Medicare abuse.
Beginning in President Donald Trump's first term, regulators increased audits, expanded data analytics to flag suspicious billing patterns and imposed stricter enrollment requirements on hospice providers, particularly in fraud-prone regions such as Los Angeles.
Federal authorities also pursued criminal prosecutions and long-term bans on providers found to be submitting improper claims.
These efforts were aimed at dismantling schemes involving "ghost patients," stolen physician identities, and sham hospice operations, issues echoed in the CBS investigation.
Despite those measures, experts say gaps remain.
"There's no reason to think that that's legitimate," Newport said, referring to the scale of cases tied to a single physician.
The hospice benefit's reliance on physician certification and limited real-time oversight continues to create vulnerabilities that can be exploited, especially in markets with rapid provider growth such as Southern California.
Trump announced last week a new effort to crack down on alleged fraud, appointing Vice President JD Vance to lead the initiative and focusing largely on Democratic-led states.
The president said there is widespread fraud in states such as California and New York and suggested addressing it could significantly affect the national budget.
James Morley III ✉
James Morley III is a writer with more than two decades of experience in entertainment, travel, technology, and science and nature.
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