LOS ANGELES — Twenty-one people are facing charges as part of a massive hospice fraud scheme that prosecutors say bilked California’s medical system out of $267 million.

Attorney General Rob Bonta on Thursday announced the results of an investigation called Operation Skip Trace. Five principal conspirators were arrested on suspicion of a host of felonies, including insurance fraud, money laundering, conspiracy and identity theft for their alleged role in a sophisticated hospice scam operating across Southern California.

If convicted, each could face at least a decade behind bars.

State prosecutors allege the defendants purchased on the dark web the personal identifying information of non-California residents and, without their knowledge, enrolled them in Medi-Cal through Covered California. The defendants then bought hospice companies and began billing the state for services they never rendered, according to the criminal complaint.

“Over the life of this fraud scheme, not a single legitimate hospice service was ever provided, yet millions were billed in a brazen, calculated scheme that exploited the Medi-Cal system,” Bonta said. “This wasn’t a mistake or a loophole; it was deliberate fraud. This kind of abuse undermines trust, drains critical resources, and threatens care for those who truly depend on it.”

Prosecutors say Robert Sabiron Rubillar and Liezyl Rubillar, the chief executive officer and chief financial officer of Legal Systems Billing Solutions, masterminded the scheme. The pair, along with the three others, were arrested Wednesday as state investigators served search warrants at 10 locations across Southern California.

They are charged with conspiracy and insurance fraud for allegedly submitting bogus claims to Medi-Cal for Cherish Hospice Inc., Emanuel Hospice and Azure Hospice Care Inc., according to a criminal complaint.

In another criminal complaint, which also names the couple, another 16 people are charged with insurance fraud, identity theft and conspiracy to commit health insurance fraud. In that complaint, prosecutors say Levon Darakchyan and Roberto Rubillar Jr. used fake patients to submit for hospice payments from the federal government for JTN Hospice, Medlight Hospice, LED Hospice, Beloved Hospice Care, Hope of LA Hospice, Sunset Hospice, Secured Hospice and TC Hospice.

The group deposited government funds into bank accounts held by other conspirators charged in the case, including $33 million into a bank account held by Sarkis Ksachikyan, according to the criminal complaint. The conspiracy, prosecutors allege, used an elaborate series of fronts, and the hospice locations were often not brick-and-mortar facilities.

“Once the money was paid out,” Bonta said, “it was funneled through a complex web of over 130 shell companies and hidden across bank accounts, payment apps and cryptocurrency to evade detection.”

State officials have recovered more than $30 million in state funds from the scheme, the attorney general said.

The charges are the latest in a series of high-profile moves made by state and federal prosecutors as both have ramped up their investigations into hospice operators. President Donald Trump and his administration have sought to portray California, particularly Los Angeles County, as the epicenter of hospice fraud.

Last week, federal authorities arrested eight people and charged 15 in an alleged scheme to steal more than $50 million in health care funds by running sham hospice facilities across Southern California.

Bonta on Thursday said federal authorities were also cracking down in Georgia, Texas and Ohio, noting that hospice fraud is happening across the country.

“To claim this is a uniquely California problem is ludicrous,” he said.

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