The CEO of a California hospice advocacy group told congressional lawmakers Tuesday that fraud in the industry is flourishing across the state, questioning how numerous fraudulent providers can continue to operate under the nose of regulators.

Sheila Clark, the president and CEO of the California Hospice and Palliative Care Association (CHAPCA) — a nonprofit that pushes to improve access to quality end-of-life care — told the House Ways and Means Committee that some hospices operate in name only, meaning they have no patients or staff.

Clark said the surge in hospice and home healthcare providers is a symptom of failures across multiple regulatory bodies that degrade patient protections and hurt taxpayers.

“You’d be amazed at how many hospices… the door you can walk up to in California and there is nobody there. Five months’ worth of mail that you can see stacked… nobody’s there,” Clark said. “And that passed a survey. How did that happen?”

“How do you put a hospice in a burrito stand in California?” she quipped. “How do you put a hospice in an entire store in California? That all had to be vetted through licensure and through certification and accreditation.”

Dr. Lynn Ianni, a licensed psychotherapist with nearly 40 years of clinical experience who also testified, said she was locked out of her own Medicare benefits for months after she was falsely enrolled in hospice care.

“Imagine being told, in effect, that you are at the end of your life — when you are not — and then being denied access to care because of that error. It was not just frustrating,” she said. “It was terrifying.”

“A Medicare representative gave me the name of the hospice where I was supposedly enrolled,” Ianni added. “I looked it up. It appeared legitimate on the surface—listed on Medicare’s own website, with an NPI number, a named CEO, and an address. But the address led to what looked like a strip mall. The phone number went unanswered.”

Republican lawmakers have called for investigations into Medicare fraud, particularly in blue states where reports have surfaced detailing hundreds of millions of dollars in fraudulent activity.

The hearing came as the Trump administration has ramped-up efforts nationwide to combat healthcare fraud.

The Task Force to Eliminate Fraud, led by Vice President JD Vance, recently suspended 447 hospices in the Los Angeles area over more than $600 million in suspected fraud. Another crackdown led to charges against more than a dozen people in a brazen multimillion-dollar scheme where people who weren’t even dying were used to bilk taxpayers out of more than $50 million.

California Gov. Gavin Newsom has pushed back on claims that his office has failed to act to combat the issue.

“FACT: The state has no role in the Medicare billing or payment process,” his press office wrote on X earlier this month in response to a CBS report on hospice fraud in California. “We are glad the Trump Admin is taking action to combat fraud. Now, if Trump could stop pardoning fraudsters—and hold them accountable—that would be great!”

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