OneCare Hospice, LLC has been kicked out of Medicare after a federal administrative law judge upheld a government move to cut off the Las Vegas company, not because its own claims were found fraudulent, but because of its legal ties to another Nevada hospice that had already lost its billing privileges. On top of the revocation, OneCare is staring at a 10-year Medicare reenrollment bar and a spot on the Centers for Medicare & Medicaid Services’ Medicare preclusion list.
The decision, issued July 9 after OneCare appealed the earlier agency action, found that federal officials were within their rights to pull OneCare’s enrollment. HHS said the affiliation with PHHC of Nevada LLC created an “undue risk of fraud, waste, or abuse” to the Medicare program under existing federal rules.
The trouble started at PHHC, which was treated as a new provider and placed into CMS’s heightened review track. Federal reviewers scrutinized 10 hospice claims submitted between Nov. 27, 2024, and Jan. 31, 2025, and denied nine of them because the records did not support a terminal prognosis of six months or less, according to KTNV. Separately, CMS notes that hospice is a Medicare Part A benefit for terminally ill patients and lists Nevada among the states facing extra program-integrity scrutiny.
OneCare and PHHC had a key link: both used Dr. Charles McSwain as a medical director. OneCare argued that McSwain oversaw only a small share of its patients and that it cut ties with him after learning PHHC had been revoked. The judge was not persuaded. The affiliation was found to be in place while PHHC’s disputed claims were being filed, and the HHS appeal decision treated a hospice medical director as a managing employee under the Medicare enrollment rules.
The ruling is administrative, not a criminal fraud conviction, and it does not state that patients were harmed. Asked about the outcome, OneCare’s attorney gave KTNV a terse response: “no comment at this time.”
Why Nevada Hospice Oversight Is Tightening
OneCare’s case lands as the federal government turns up the heat on hospice oversight nationwide. CMS has imposed a six-month nationwide moratorium on new hospice and home health agency enrollments beginning May 13, 2026, while its own hospice oversight program reports that enhanced review for newly enrolling hospices in Nevada started in July 2023.
What The Decision Does And Does Not Change
The order speaks to OneCare’s ability to participate in Medicare, not to any criminal prosecution or automatic shutdown of its state-level business operations. The Clark County business database currently shows OneCare’s local business license as active. That record, however, does not indicate whether the company can bill Medicare, which is the specific issue decided in the federal administrative process.
