Attorney General Bonta: 103 Criminal Cases Filed in Statewide Medi-Cal Fraud Enforcement Efforts

LOS ANGELES - California Attorney General Rob Bonta today announced the results of a statewide effort over the last year targeting fraud in California's In-Home Supportive Services (IHSS) program. As a result of these efforts, felony charges were filed against 103 individual IHSS providers for allegedly defrauding the Medi-Cal program out of over $4.5 million dollars.

"By enabling parents to care for their adult children with disabilities and allowing elderly individuals to age in place, IHSS provides a vital lifeline for families across the state. We are here to protect that lifeline," said Attorney General Rob Bonta. "This isn't a political game for us. This is about protecting taxpayer dollars, protecting the programs that sick and vulnerable Californians rely on, and protecting our state. While the alleged fraud represents a small fraction of California's $30 billion IHSS budget, any abuse of Medi-Cal jeopardizes funding for our most vulnerable residents. This statewide enforcement action ensures the integrity of the IHSS program so that every individual who genuinely needs care receives it. It is proof that we have taken a firm stand to investigate, prosecute, and shut down Medi-Cal fraud wherever it exists."

The California Department of Justice (DOJ), in partnership with the Department of Health Care Services, which administers Medi-Cal, undertook a coordinated effort to review and investigate referrals generated through program integrity activities, including data analytics and claims review. Today's announcement reflects the results of a years-long, coordinated statewide effort focused on developing leads to investigate IHSS care providers who unlawfully billed Medi-Cal, claiming hours for care while the member was admitted to an acute care hospital or skilled nursing facility, also paid for by Medi-Cal. DOJ data mining auditors, Special Agents, and Special Investigators, investigated IHSS providers from Butte County to San Diego County, including credible allegations of fraud referred by DHCS investigators, resulting in the filing of 103 cases throughout the State. The members lived in the counties of Butte, Contra Costa, Fresno, Kern, Lake, Los Angeles, Napa, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Santa Clara, Solano, Sonoma, and Tulare.

California's In-Home Supportive Services (IHSS) program, funded through Medi-Cal, serves over 900,000 seniors and individuals with disabilities annually, allowing beneficiaries to remain in their homes rather than entering long-term nursing facilities. This home-based care model is federally approved and reduces public spending by approximately $100,000 per person annually compared to nursing facility care. The fraud cases announced today represent a fraction of the total IHSS caseload and prove that California has robust systems to hold bad actors accountable.

To report suspected IHSS fraud:
Submit a Complaint Online at https://oag.ca.gov/dmfea/reporting
Call DOJ's Division of Medi-Cal Fraud & Elder Abuse Complaint Line Toll-free at: (800) 722-0432
Send a Written Complaint by Mail:
California Department of Justice
Division of Medi-Cal Fraud and Elder Abuse
P.O. Box 944255
Sacramento, CA 94244-2550

The Division of Medi-Cal Fraud and Elder Abuse (DMFEA) is a division in the California Department of Justice whose mission is to protect citizens and the state's Medi-Cal program from those who defraud taxpayers and divert state health care resources. In addition, DMFEA is focused on ensuring that the IHSS program continues to work effectively for Californians and remains free from fraud, waste, and abuse. This is a part of the ongoing efforts to tackle Medi-Cal fraud in all its various forms. Recently, DMFEA:

• Secured a guilty plea against Maki Martinez-Gruninger for a felony charge of defrauding the Medi-Cal program and he will serve two years in state prison for stealing more than $400,000 from the State of California through a scheme that exploited a disabled family member.
• Joined federal partners in the 2026 National Health Care Fraud Takedown, a coordinated law enforcement operation that resulted in criminal charges against 455 defendants nationwide with over $6.5 billion in intended losses.
• Filed charges against 21 suspects and the dismantling of a major hospice fraud scheme that defrauded California of $267 million.
• Announced the arrests of and filing of multiple felony charges against seven individuals for hospice fraud in Monterey County.
• Secured sentencing of Inland Empire Hospice operators, Ralph and Rochell Canales, for submitting false claims to the Medicare and Medi-Cal programs.
• Launched a new initiative aimed at educating the public and providing vital reporting resources to individuals and families who may have been impacted by hospice fraud.
• Secured sentencing of a Southern California healthcare clinic operator, Oscar B. Abrons III, for his involvement in a prescription medication diversion scheme that defrauded Medi-Cal, the state's Medicaid program, of more than $20 million.

The Division of Medi-Cal Fraud and Elder Abuse within the California Attorney General's Office receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award, totaling $85,882,152 for Federal Fiscal Year (FFY) 2027. The remaining 25 percent, totaling $28,627,384 for FFY 2027, is funded by the State of California. FFY 2027 is from October 1, 2026 through September 30, 2027.

It is important to note that a criminal indictment contains charges that are only allegations against a person. Every defendant is presumed innocent until proven guilty.