Nick Shirley: Fraud is rampant in US elections and healthcare, California’s Medi-Cal budget raises red flags, and organized crime exploits hospice care | Shawn Ryan Show

2 hours ago 3

Key takeaways

Fraud is a pervasive issue in the US, impacting various sectors.
California’s lack of voter ID requirements potentially facilitates election fraud.
A new task force aims to improve communication between government departments to combat financial fraud.
California’s Medi-Cal program has seen significant budget growth, raising fraud concerns.
California’s budget has shifted from a surplus to a significant deficit.
The complexity of California’s healthcare funding poses challenges to fraud detection.
Medicare beneficiary numbers are highly valuable to fraudsters.
Hospice care in California is particularly susceptible to fraud, with organized crime involvement.
The hospice system’s billing practices make it vulnerable to fraud.
One third of the hospices in the US are located in LA County, indicating potential oversight issues.
The concentration of hospices in LA County suggests challenges in healthcare quality.
Organized crime’s involvement in hospice care highlights systemic vulnerabilities.
The lack of direct oversight in hospice billing facilitates fraudulent activities.
Seniors’ Medicare numbers are more valuable to fraudsters than credit cards.
California’s fiscal health has drastically changed, impacting public services.

Guest intro

Nick Shirley is an independent journalist and YouTuber known for on-the-ground investigations into government fraud. He gained national attention with a December 2025 viral video exposing over $100 million in alleged fraud in Minnesota’s government-funded childcare programs. His latest work uncovers $170 million in suspected daycare and Medi-Cal fraud in California, part of the state’s $222 billion program.

The prevalence of fraud in the US

There is so much fraud here in the United States it’s unbelievable

— Nick Shirley
Fraud affects multiple sectors, including elections and healthcare.
California’s voter ID laws are seen as a vulnerability for election fraud.
They’re one of the states that don’t require voter ID so I really just wanna show people how easy it is to vote

— Nick Shirley
The lack of voter ID requirements is a critical issue for election integrity.
Fraud detection efforts are hampered by lack of inter-departmental communication.
A new task force aims to enhance communication to address financial fraud.
All these departments inside the government… are now gonna be talking together

— Nick Shirley
The task force is expected to lead to increased prosecutions.
Understanding the scope of fraud is essential for effective policy responses.

California’s healthcare system and fraud vulnerabilities

California’s Medi-Cal program budget has increased significantly.
In 2022 they had a $108,000,000,000 go towards Medi-Cal

— Nick Shirley
The program’s enrollment has also seen a massive rise.
The increase in budget and enrollment raises concerns about potential fraud.
The proposed budget for Medi-Cal is now 222,000,000 and their enrollments 40,000,000

— Nick Shirley
The complexity of healthcare funding makes fraud detection challenging.
They wanna make it so big and so complex that it’s hard to actually crack down on

— Nick Shirley
Protecting seniors’ Medicare numbers is crucial due to their high value to fraudsters.
Medicare beneficiary numbers are more valuable than credit cards to fraudsters.
Fraudsters target seniors due to the value of their healthcare information.

Financial challenges and implications for public services

California’s budget has shifted from a surplus to a deficit.
California at one point is operating a $100,000,000,000 surplus before 2020 now they’re operating in a… $20 to $40,000,000,000 deficit

— Nick Shirley
The fiscal changes have implications for public service funding.
Understanding these changes is crucial for assessing California’s financial health.
The deficit impacts the state’s ability to provide essential services.
The shift in budgetary status highlights the need for fiscal accountability.
California’s financial health is a critical issue in the broader context of state governance.
The budget deficit underscores the importance of effective financial management.

Hospice care fraud and organized crime involvement

Significant fraud is occurring in California’s hospice care system.
There’s thousand percent increase in these hospices Armenia and Russian mafias are running these hospices

— Nick Shirley
Organized crime’s involvement highlights systemic vulnerabilities.
The hospice system allows for billing without direct patient oversight.
It’s very hard okay so if you do have that medical beneficiary number it’s super easy to make it look like you’re doing stuff

— Nick Shirley
The lack of oversight facilitates fraudulent activities.
One third of the hospices in America are located in LA County.
One third of the hospices in America are in LA County

— Nick Shirley
The concentration of hospices suggests potential oversight issues.
The distribution of hospices raises questions about healthcare quality in urban areas.
Addressing hospice care fraud requires targeted policy interventions.