An Anaheim woman pleaded guilty Thursday to a federal health care fraud charge for submitting more than $2.2 million in fraudulent Medicare claims for hospice care provided to patients who were not terminally ill.
Lynn Galbraith, 60, pleaded guilty to one count of health care fraud and faces up to 10 years in federal prison, according to the U.S. Attorney’s Office.
U.S. District Judge John A. Kronstadt scheduled sentencing for Dec. 3.
Galbraith co-owned and operated Garden Grove-based Azure Hospice Care Inc. from September 2019 until July 2022, when she became the company’s sole owner, prosecutors said. She remained the sole owner until February 2024.
According to her plea agreement, Galbraith knowingly submitted or caused the submission of Medicare claims for hospice services involving beneficiaries who did not have a terminal illness with a life expectancy of six months or less.
Prosecutors said Galbraith either knew the patients did not qualify for hospice care or knew their medical records did not contain sufficient documentation supporting a diagnosis and prognosis that qualified them for Medicare hospice benefits.
She also did not routinely coordinate with the patients’ primary care physicians regarding their purported conditions or terminal prognoses, according to the U.S. Attorney’s Office.
In one instance in October 2022, Galbraith submitted a $6,600 Medicare claim for hospice services provided to a beneficiary despite knowing there was insufficient medical documentation to establish the patient’s eligibility for hospice care, prosecutors said.
Galbraith admitted submitting approximately $2.27 million in fraudulent claims to Medicare on behalf of Azure Hospice Care, with Medicare paying the company approximately $2.14 million.
The U.S. Department of Health and Human Services Office of Inspector General investigated the case.