Dr. Victor Contreras sentenced to 24 months for over $3 million in fraudulent Medicare claims

LOS ANGELES, Calif. – Dr. Victor Contreras of Santa Paula was sentenced to 24 months in federal prison for defrauding Medicare for more than $3 million in claims for medically unnecessary hospice services.

The 69-year-old was sentenced on Monday and also required to pay $3,289,889 in restitution added the U.S. Attorney's Office for the Central District of California in a press release.

Contreras previously pleaded guilty to one count of healthcare fraud in July of this year.

According to the U.S. Attorney's Office, from July 2016 to February 2019, Contreras and co-defendant Juanita Antenor schemed to defraud Medicare by submitting millions of dollars worth of false or fraudulent claims for hospice services through two Pasadena-based companies: Arcadia Hospice Provider Inc. and Saint Mariam Hospice Inc., both owned by Antenor.

Medicare only covers hospice services for terminally ill patients, meaning they only have a life expectancy of six months or less if their illness ran its normal course.

Contreras falsely stated on claims forms that patients had terminal illnesses, making them eligible for hospice services covered by the federal program, usually by adopting diagnoses provided to him by hospice employees, regardless of their veracity detailed the U.S. Attorney's Office.

According to the U.S. Attorney's Office, Contreras was making these diagnoses for patients even when he was not their primary care physician and had not spoken to their primary care physicians about their medical status.

Medicare paid out those claims based on Contreras' false evaluations, certifications, and recertifications explained the U.S. Attorney's Office.

A total of about $3,917,946 in fraudulent claims were submitted to Medicare of which a total of $3,289,889 was officially paid out stated the U.S. Attorney's Office.

Contreras is a licensed physician in California, but has been on probation since 2015 and is subject to limitations on his practice of medicine noted records from the Medical Board of California.

Currently, Antenor remains at large shared the U.S. Attorney's Office.

Another co-defendant, Callie Black of Lancaster, pleaded not guilty to charges related to recruiting patients for the Pasadena hospice companies allegedly in exchange for illegal kickbacks stated the U.S. Attorney's Office.

Black's trial is scheduled to begin in March of 2025, detailed the U.S. Attorney's Office.