Santa Paula physician convicted of defrauding Medicare for more than $3 million Wednesday
LOS ANGELES, Calif. – On Wednesday, Dr. Victor Contreras, a Santa Paula physician, pleaded guilty to defrauding Medicare for more than $3 million by billing the federal program for medically unnecessary hospice care.
According to his plea agreement, Contreras and co-defendant Juanita Antenor defrauded Medicare by submitting almost $4 million in false and fraudulent claims for hospice services through two Pasadena-based hospice facilities: Arcadia Hospice Provider Inc. and Santa Mariam Hospice Inc.
Both of those companies were controlled by Antenor shared the Department of Justice in a press release about the conviction Wednesday.
Medicare only covers hospice services for patients who are terminally ill, defined as a life expectancy of six months or less if their illness ran its normal course explained the Department of Justice.
According to the Department of Justice, Contreras falsely stated on claims forms that patients had terminal illnesses to make them eligible for services covered by Medicare, typically adopting diagnoses from hospice employees.
Contreras made those claims despite not being any of the patient's primary care physician and having never spoken to any of the patient's primary care physicians about their conditions shared the Department of Justice.
Approximately $3,917,946 in fraudulent claims were submitted to Medicare which paid out about $3,289,889 detailed the Department of Justice.
Contreras is currently a licensed physician in California, but has been on probation since 2015 and is subject to limitations on his practice of medicine in the state show Medical Board of California records.
Contreras is scheduled for sentencing on Oct. 25, where the 68-year-old faces a statutory maximum sentence of ten years in federal prison shared the Department of Justice.
Another co-defendant, Callie Black of Lancaster, is facing charges for allegedly recruiting patients for the above hospice companies in exchange for illegal kickbacks and is currently scheduled to go to trial on Oct. 15 explained the Department of Justice.
Black has entered a plea of not guilty regarding those allegations.
Antenor remains at large stated the Department of Justice in a press release Wednesday, July 24.
