An Orange County woman pleaded guilty on August 27 to a federal health care fraud charge for submitting more than $2.2 million in false Medicare claims for hospice care that patients who were not actually dying should never have received. Lynn Galbraith, 60, of Anaheim, admitted in her plea agreement that she billed Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less. She faces sentencing in December and a statutory maximum of ten years in federal prison.
What Galbraith Admitted in Her Plea Agreement
Galbraith co-owned and operated Garden Grove-based Azure Hospice Care Inc. from September 2019 until July 2022, when she became its sole owner; she remained sole owner until February 2024. According to her plea agreement, she knowingly submitted or caused the submission of Medicare claims for hospice services for beneficiaries who did not qualify — either because she knew they were not terminally ill, or because she knew the medical record did not support the terminal diagnosis and six-month prognosis Medicare requires. Galbraith knew and intended that Medicare would rely on her false representations about patients’ eligibility, and that reliance is what caused Medicare to send payment to Azure Hospice Care for the claimed services, prosecutors said. She also did not routinely coordinate with beneficiaries’ own primary care physicians about their supposed conditions.
Prosecutors point to one specific example: in October 2022, Galbraith submitted a $6,600 claim to Medicare for hospice services for a beneficiary, knowing the medical record did not establish that the person actually qualified for hospice care in the first place.
Free retirement updates: Miss an enrollment or claim deadline and it may be gone. Our free Retirement Shield newsletter keeps readers ahead of the ones that matter. Get the free newsletter.
Why Electing Hospice Changes What Medicare Will and Won’t Pay
The reason hospice eligibility matters so much is that hospice is not an add-on benefit — it replaces standard Medicare coverage for the terminal condition. Under Medicare’s own hospice coverage rules, a beneficiary qualifies only if a hospice doctor and their regular doctor certify a terminal illness with a life expectancy of six months or less, and the patient signs a “Hospice Election Statement” choosing hospice care instead of other Medicare-covered treatment for that illness. Once elected, Medicare stops paying for treatment intended to cure the terminal illness or for prescription drugs meant to cure it rather than manage pain and symptoms; coverage instead runs in two 90-day benefit periods followed by an unlimited number of 60-day periods, each requiring a fresh certification from a doctor.
That trade-off is exactly why prosecutors treat false hospice enrollment as more than a billing technicality. A patient who is not actually terminal but is billed as if they qualify for hospice can lose access to the regular curative treatment Medicare would otherwise cover for their condition, on top of the taxpayer money the false claims divert from the program. Medicare’s rules do give beneficiaries some protection against staying trapped in an inappropriate enrollment — they can switch hospice providers once during a benefit period, and they can revoke the hospice election entirely to return to standard Medicare coverage if their prognosis or their wishes change.
How $2.27 Million in Claims Became $2.14 Million in Medicare Payments
According to the U.S. Attorney’s Office for the Central District of California, Galbraith submitted approximately $2,266,694 in false claims to Medicare on behalf of Azure Hospice Care, and Medicare ultimately paid the company approximately $2,140,606 of that total. The roughly $126,000 gap between the two figures reflects Medicare’s standard claims processing and adjustment, not money already clawed back — any restitution will be determined separately at sentencing rather than through a refund process already underway. The same U.S. Attorney’s office has recently pursued other health care fraud cases in the region, including a Pasadena wound-care clinic accused of a Medicare fraud scheme and a Burbank lab owner sentenced for tax evasion tied to Medicare billing — a sign hospice and home-health billing remain an active target for investigators in Southern California.
What Comes Next: A December Sentencing and a Ten-Year Ceiling
U.S. District Judge John A. Kronstadt has scheduled Galbraith’s sentencing for December 3. A guilty plea to one count of health care fraud carries a statutory maximum of ten years in federal prison, though actual sentences in cases like this typically fall well below that ceiling once a court weighs the federal sentencing guidelines, the total loss amount, and the defendant’s plea and cooperation. The case was announced as part of the Justice Department’s National Fraud Enforcement Division, created in April to concentrate investigations and prosecutions of fraud against federal programs. The U.S. Department of Health and Human Services Office of Inspector General investigated the case, and Assistant U.S. Attorney Rosalind Wang of the Orange County office is prosecuting it. Until sentencing, the $2.2 million figure in the plea agreement describes the scope of the admitted fraud rather than a final financial judgment against Galbraith — any restitution amount a judge orders will be set separately at the December hearing, based on the loss figures both sides agree to at that time.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
More Financial Reading
