A Santa Paula, Calif., physician has been sentenced to two years for defrauding Medicare of more than $3 million for medically unnecessary claims.
While working at two different Pasadena-based hospices –– Arcadia Hospice Provider and Saint Mariam Hospice –– Victor Contreras, MD, billed Medicare for medically unnecessary hospice services, according to a Dec. 8 news release from the Justice Department.
According to the 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.
Dr. Contreras pleaded guilty on July 24 to one count of healthcare fraud.