The billing trail uncovered in public Centers for Medicare and Medicaid Services (CMS) data ties a registered dermatologist, Dr. Fariba Javaherian, to an unusually large volume of hospice claims. The records show her NPI — the 10-digit national provider identifier assigned to clinicians — appearing on thousands of claims across scores of agencies, producing billing totals that reached into the tens of millions.
The disclosure prompted federal action: after the reporting, CMS revoked Javaherian’s right to bill Medicare and moved to stop payments to suppliers closely connected to her. The case raises questions about how hospice billing is authorized, how vendor platforms are used by agencies, and what protections exist for clinicians whose credentials may be misused.
What the billing records reveal
Public CMS billing files show Javaherian’s NPI appearing across a wide network of hospice providers. In the most recent year reported, her identifier was listed for 1,662 unique patients across 63 hospice facilities, appearing on over 6,000 claims that billed Medicare roughly $35,816,331. When the timeline is widened, between Jan. 1, 2018 and Sept. 30, 2026, her NPI shows up on more than 31,000 claims at about 130 agencies, totaling in excess of $173 million. These figures are central to the scrutiny of whether normal clinical oversight and documentation were present.
Scale of charges
The sheer numbers — thousands of claims and eight-figure totals — alarmed hospice clinicians and regulators. Veteran hospice medical directors told investigators that an individual provider’s effective clinical oversight becomes implausible once caseloads exceed certain limits, and that numbers in the hundreds of patients attributed to a single physician would be difficult to reconcile with high-quality, hands-on care. The records naming Javaherian as medical director, attending physician or in another role triggered that same concern.
Claims timeline and facility spread
Data demonstrates not only concentrated billing in one year but a pattern stretching over several years and across many locations. Some agencies listed Javaherian as the only physician on file for an entire year, yet CMS claims data showed no patient deaths recorded there in 2026, a discrepancy that investigators flagged as inconsistent with typical hospice caseload outcomes.
Responses from regulators and providers
After reviewing evidence, CMS revoked Javaherian’s Medicare enrollment and said it suspended payments to providers closely affiliated with her, citing coordination with Vice President Vance’s Fraud Taskforce. CMS spokesman Christopher Krepich described the action as based on substantial evidence and pledged continued monitoring. CMS Administrator Dr. Mehmet Oz criticized the conduct reflected in the billing data and described the situation as contrary to the clinical principle of “do no harm.”
Agency suspensions and terminations
At least 16 hospice agencies identified in the reporting have had licensing actions, including suspensions, and several facilities were terminated from Medicare certification in 2026 for failing to meet federal standards. CMS said it also moved to stop payments to businesses associated with Javaherian while investigations proceed.
Vendor and clinician claims
Javaherian has denied knowingly working for dozens of hospices, asserting she was a victim of identity misuse and alleging that a third-party electronic records vendor — HospiceMD — was involved in creating accounts that used her credentials. HospiceMD said it is a software vendor that does not create or manage hospice agencies and urged anyone alleging credential misuse to report it to investigators. The vendor has not been accused of wrongdoing.
Connections, gaps and outstanding questions
The investigation also highlights links to other convicted actors: Javaherian appears on claims alongside Domingo Barrientos, who pleaded guilty in 2026 to conspiracy to commit health care fraud and was ordered to repay more than $10,123,260 and serve a federal sentence. While Javaherian has not been charged, her presence on the same claims inventory has intensified scrutiny.
State agencies, including the California Department of Public Health and a county district attorney, reported reviewing allegations but have offered limited public comment. Javaherian says she contacted those offices repeatedly, but she declined to provide documentation of routine notifications when asked. Regulators note there is no formal requirement for doctors to submit monthly lists to state health departments, and at least one prosecutor’s office confirmed limited contact without an active investigation on file.
Broader implications
The case underscores vulnerabilities in the hospice payment system and the potential for large-scale financial loss: sources estimate billions flow through home health and hospice programs annually in the greater Los Angeles area alone. Whether through improper credentialing, vendor account manipulation, or agency-level fraud, the episode has prompted tighter enforcement steps by federal officials and raised calls for better safeguards around NPI usage, vendor controls and real-time oversight of Medicare billing.
As federal and state agencies continue probing the records and linked providers, stakeholders say the outcome could reshape oversight practices for hospice certification, vendor access to clinician credentials, and how quickly suspicious billing patterns trigger enforcement.
