A Santa Paula (Calif.) physician pleaded guilty in federal court to one count of healthcare fraud for defrauding Medicare out of more than $3 million.
While working at two different Pasadena-based hospices –– Arcadia Hospice Provider nad Saint Mariam Hospice –– Victor Contreras, MD, billed Medicare for medically unnecessary hospice services, according to a July 24 news release.
Dr. Contreras falsely stated on claim forms that patients had terminal illnesses that would qualify them for Medicare hospice service coverage. He adopted diagnoses provided to him by hospice employees regardless of their validity or without speaking to those patients' primary care physicians. Medicare paid on Dr. Contreras' false evaluations and claim submissions.
Juanita Antenor is alleged to have assisted Dr. Contreras in the scheme and remains at large. Another co-defendant, Callie Black, who allegedly recruited patients for the hospice facilities in exchange for illegal kickbacks, has pleaded not guilty and will go to trial on Oct. 15.
Dr. Contreras has been on probation with the Medical Board of California since 2015 and is subject to limitations on his practice. Sentencing is scheduled for Oct. 25. He faces up to 10 years in federal prison.