Staff Reports
At an April Texas Senate hearing, Lisa McNair, president and CEO of Hospice Brazos Valley, dropped a whistle into a hornet’s nest. Her testimony laid out a pattern of suspicious hospice licensing and Medicare billing that smells a lot like fraud. If taxpayers and families thought hospice was safe ground, McNair’s presentation should change that view in a hurry.
What McNair told the Texas Senate
McNair told the Senate Committee on Health and Human Services that the number of hospice licenses in Texas has exploded — roughly 1,366 licensed hospices, with 998 Medicare‑certified and hundreds serving Medicare patients last year. She showed charts and examples of dozens of separate hospice licenses tied to the same address. In some cases, one owner listed as many as 15 different hospice entities at a single building. That’s not expansion of care; that’s a shell game with Medicare billing.
Data points that should alarm every Texan
The slide deck McNair presented included striking red flags: 833 new hospice licenses issued in Texas from 2021–2025, many co‑located, many sharing administrators. She also highlighted impossible outcomes — several hospices reporting 100% “live‑discharge” rates and many more with unusually high live discharges. Hospice is for people at the end of life. When every patient walks out alive, someone is gaming the system and taxpayers are footing the bill.
Why federal and state regulators are now watching
CMS already put new measures in place — the Provisional Period of Enhanced Oversight — to stop this type of gaming in high‑risk states. CMS Administrator Dr. Mehmet Oz and state leaders, including Governor Greg Abbott, have signaled tougher scrutiny. The California takedown of a massive hospice fraud ring is proof this isn’t theoretical; it’s a playbook, and the same red flags McNair described match patterns prosecutors have used elsewhere.
Fixes are obvious — if officials have the stomach for them
Texas regulators should stop treating licenses like party favors. Require ownership transparency, audit co‑located addresses, and use pre‑payment reviews where billing spikes look suspicious. Law enforcement should be allowed to move fast when patients are being enrolled without consent. And yes, anyone caught using hospice as a revenue factory should face the harshest penalties the law allows. This isn’t about over‑regulation; it’s about saving lives and stopping theft from seniors and taxpayers.
McNair’s testimony is a clear call to action. Lawmakers and regulators can either clean up a system being abused under their watch or keep offering lucrative cover for people who weaponize compassion into a money machine. Texans — and taxpayers nationwide — deserve better than hospice on paper and fraud in practice. It’s time to shut down the shell games and protect the vulnerable.
