Hospice Care Integrity: Addressing Legitimate Providers Amid Fraud Concerns

An established hospice care professional has come forward to defend the industry while acknowledging that fraud does occur. Kevin Tutunjian, the founder of In the Arms of Grace Hospice, which he established in 2011, operates a fully legitimate, community-focused organization in Los Angeles. He emphasizes that while the situation is complex, many in the hospice sector are dedicated and hardworking.

“Blatant fraud involves billing Medicare without the patient’s awareness, and that’s a different issue,” Tutunjian explained. “However, there are organizations striving to do the right thing that may not be fully equipped to provide high-quality care for various reasons.”

In a conversation with The Post, Tutunjian conceded that fraudulent activities do exist within the industry, but he is skeptical of claims suggesting the problem amounts to billions of dollars. He urged authorities to engage more with industry experts when formulating strategies to address allegations of widespread fraud.

“If you had looked at the situation five years ago, that kind of approach might have been relevant. But I believe the current landscape is different,” Tutunjian noted, clarifying that his comments are specifically about hospice care and not the broader home health sector.

Tutunjian told The Post that fraud does exist, but he doubts it’s anywhere in the billions. He called on authorities to consult the industry more when working out how to tackle claims of widespread fraud in the industry.

“I think if you came here like five years ago, maybe that would have been appropriate. But I think now it might not be the same,” He said, adding that he is specifically talking about hospice, and not home health. 

In 2022 Governor Gavin Newsom signed legislation placing a moratorium on new hospice licenses. 

Tutunjian, who is also a long time California Hospice and Palliative Care Association (CHAPCA) board member, said by that time too many licenses had already been issued and created the perception of widespread fraud. 

“Why did we issue so many licenses and then turn around and say, look how many hospices there are — they’re all committing fraud,” he said. 

California has 2,836 licensed hospice agencies, with more than 1,800 in Los Angeles alone, according to a 2022 state audit report — by comparison New York had 43 and Florida had 44. 

In 2019, Los Angeles County had six times the national average number of hospice agencies relative to its aged population. 

Tutunjian said the focus, however, should be on educating the public on how to identify a compliant and high-quality hospice — starting with accreditation and having strong quality and compliance programs. 

He added that families need to ask the right questions when evaluating a hospice, including finding what services are whether they provide any ancillary or specialty programs. 

“Do they have a volunteer program? Do they have a bereavement care program? All of this is essential in evaluating the quality of a program,“ Tutunjian said. “It goes back to educating the public and the consumer on the right questions to ask.” 

As Dr. Oz ramps up his investigation into California’s health sector, Tutunjian said he hopes organizations like his, that are on the frontlines, will be included in crafting solutions to prevent further waste, fraud and abuse. 

“Providers and stakeholders need to be at the table, we need to be a part of the conversation, and we need to be a part of the solution,” he said.