加州全州打击居家护理欺诈：103名IHSS提供者被控重罪 涉案逾450万美元
洛杉矶——加州总检察长 Rob Bonta 10月22日宣布，加州司法部（California Department of Justice）公布过去一年全州打击居家支持服务（In-Home Supportive Services，IHSS）欺诈的执法结果：103名IHSS护理提供者被提起重罪指控，被指骗取加州医疗补助计划 Medi-Cal 逾450万美元。
据加州司法部通报，这些提供者被指在受护者入住同样由 Medi-Cal 付费的急症医院或专业护理机构期间，仍就同一时段的居家护理向 Medi-Cal 申报工时。司法部与负责管理 Medi-Cal 的加州医疗保健服务厅（California Department of Health Care Services）合作，通过数据分析与理赔审查梳理项目诚信线索，开展多年的全州协调调查；案件中受护者分布于 Butte、Contra Costa、Fresno、Kern、Lake、Los Angeles、Napa、Orange、Riverside、Sacramento、San Bernardino、San Diego、San Joaquin、Santa Clara、Solano、Sonoma 与 Tulare 等17个县。
IHSS 由 Medi-Cal 出资，每年为逾90万名老年人与残障人士提供居家照护，使受护者可以留在家中、而不必入住长期护理机构；加州司法部称，这一居家模式与护理机构照护相比，每人每年可节省约10万美元公共支出，IHSS 年度预算约300亿美元。Bonta 在通报中表示，IHSS 是全州家庭的重要生命线：「这不是一场政治游戏。这是关于保护纳税人的钱、保护病人和弱势加州人所依赖的项目，并保护我们的州。」他表示，被指欺诈金额只占 IHSS 预算的一小部分，全州执法行动旨在维护该项目的完整性。
加州司法部表示，其下属的 Medi-Cal 欺诈与老人虐待司负责此类案件的调查与起诉，该司近期还参与了2026年全国医疗保健欺诈打击行动，并办理了多起临终关怀欺诈案件。司法部同时提醒，刑事指控只是指控，每名被告在被证明有罪之前均被推定无罪。
关联：
司法部洛杉矶医疗诈骗大清查：15人被起诉涉虚假申报逾18亿美元 含史上最大假戒毒康复案
California Charges 103 IHSS Providers With Felonies in Statewide Medi-Cal Fraud Enforcement
LOS ANGELES — California Attorney General Rob Bonta announced on October 22 that the California Department of Justice has filed felony charges against 103 individual In-Home Supportive Services (IHSS) providers for allegedly defrauding the Medi-Cal program of more than $4.5 million, the results of a statewide enforcement effort over the past year targeting fraud in the IHSS program.
According to the Department of Justice, the providers allegedly 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. The department worked with the California Department of Health Care Services, which administers Medi-Cal, reviewing referrals generated through program integrity activities including data analytics and claims review. The members in the cases lived in 17 counties: Butte, Contra Costa, Fresno, Kern, Lake, Los Angeles, Napa, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Santa Clara, Solano, Sonoma, and Tulare.
Funded through Medi-Cal, IHSS serves more than 900,000 seniors and individuals with disabilities each year, allowing them to remain in their homes rather than enter long-term nursing facilities; the Department of Justice said the home-based model reduces public spending by approximately $100,000 per person annually compared with nursing facility care, and the IHSS budget is about $30 billion. Bonta said IHSS provides a vital lifeline for families across the state: "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." He said the alleged fraud represents a small fraction of the IHSS budget, and that the enforcement action is meant to ensure the program's integrity.
The Department of Justice said its Division of Medi-Cal Fraud and Elder Abuse handles such cases and recently joined federal partners in the 2026 National Health Care Fraud Takedown, alongside a series of hospice fraud prosecutions. The department noted that the charges are only allegations, and every defendant is presumed innocent until proven guilty.
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图片来源：图：Fresno 一名居家护理人员协助长者做康复活动（资料图）。照片：Ronaro56，CC BY-SA 4.0，经 Wikimedia Commons。 / A home care worker assists a senior with rehabilitation exercises in Fresno (file photo). Photo: Ronaro56, CC BY-SA 4.0, via Wikimedia Commons.
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