IHSS (In-Home Supportive Services) is a California program providing in-home care to eligible aged, blind, or disabled individuals, primarily funded by the state with federal matching. Fraud typically involves providers claiming hours not worked, recipients overstating needs, collusion between providers and recipients, identity theft, or billing for unprovided services. Common charges include grand theft, false claims, and welfare fraud under California Penal Code sections.

The California Department of Social Services (CDSS) tracks program integrity through annual reports. Fraud complaints and investigations occur, but criminal prosecutions and convictions represent a small fraction of cases, as many are resolved administratively (e.g., overpayment recovery, service reductions, or terminations). Provider fraud accounts for the vast majority (~80-83%) of investigated cases.

Recent news (as of 2026) shows ongoing but limited high-profile IHSS-specific convictions reported publicly; one 2026 LA County DA case involved an IHSS caregiver convicted after surveillance showed physical capabilities contradicting claimed needs.

The Special Investigative Unit of RJN Investigations, Inc. was recently notified by the Los Angeles County District Attorney’s Office of their successful prosecution in the case of People of The State of California v M. Lopez based upon a documented fraud referral.

In this case, the claimant was employed as a caretaker of the California Department of Social Services – I.H.S.S. At the time of the claimant’s deposition, he appeared wearing a back support and ambulating with the aid of a cane.

Proactively, the Senior Claims Examiner authorized the RJN SIU Department to perform RUSH surveillance. During the ongoing surveillance, extensive video evidence was obtained depicting the claimant ambulating freely without any noticeable signs of artificial support or noticeable restrictions. The video evidence was subsequently provided to the QME for review and comment. In his QME report, it stated in part the following:

“Overall, review of the subrosa video footage demonstrates a degree of inconsistency between what Mr. Lopez reported and exhibited at the time of the PQME examination, and what he was visualized performing during the video segments…My reporting on this case has changed as a result of this additional information and my revised reporting follows below…”

In compliance with the regulations set forth by the California Department of Insurance Fraud Division, the RJN SIU formally filed this case with their office as well as with the Los Angeles County District Attorney’s Office.

Felony charges were then issued against the claimant, and a preliminary criminal hearing was set. The claimant failed to appear for the hearing and as a result, a felony bench warrant was issued for his arrest.

The claimant subsequently had formal interactions with law enforcement and their check of NCIC revealed his felony warrant where he was promptly arrested. After several criminal hearings, the claimant entered into a plea bargain agreement entailing formal probation and having to pay restitution in the amount of $ 43,263.00.