A Ventura County doctor has admitted to his role in a hospice scam that swindled Medicare out of approximately $3.2 million. Dr. Victor Contreras, 68, of Santa Paula, entered a guilty plea to one count of healthcare fraud, according to a press release from the U.S. Attorney's Office for the Central District of California. From July 2016 to February 2019, Contreras and his co-defendant allegedly defrauded Medicare by submitting false claims for non-terminally ill patients at two hospice companies.
The deceitful activities were centered around Arcadia Hospice Provider Inc., and Saint Mariam Hospice Inc., where Medicare was billed for hospice care for patients not terminally ill. Contreras, in exchange for financial reward, affirmed these patients required end-of-life care without proper assessment or discussions with their primary care physicians. The Medicare program relies heavily on the veracity of doctors' certifications to appropriately allocate its limited funds for patients in genuine need.
Contreras' plea agreement reveals that he adopted diagnoses given to him by hospice employees without verification, leading to Medicare paying out on falsely supported claims. Almost $4 million in fraudulent claims were submitted, with Medicare disbursing approximately $3,289,889.
Despite his conviction, Medical Board of California records show that Dr. Contreras is still a licensed physician in California, albeit on probation since 2015 with limits on his practice. Senior District Judge André Birotte Jr. has scheduled his sentencing for October 25, where Contreras faces up to 10 years in a federal prison. Juanita Antenor, another figure in the scheme, is still at large while co-defendant Callie Black awaits trial on October 15 after pleading not guilty to related charges.
This case was investigated by the United States Department of Health and Human Services Office of Inspector General, the FBI, and the California Department of Justice. The prosecution is being overseen by Assistant United States Attorneys Kristen A. Williams of the Major Frauds Section and Aylin Kuzucan of the General Crimes Section. For further details on the plea, officials have directed inquiries to Ciaran McEvoy, Public Information Officer.
