A Ventura County physician who worked for two Pasadena hospices pleaded guilty to defrauding Medicare out of more than $3 million by billing the public health insurance program for medically unnecessary hospice services. Dr. Victor Contreras, 68, of Santa Paula, pleaded guilty to one count of healthcare fraud. According to his plea agreement, from July 2016 to February 2019, Contreras and co-defendant Juanita Antenor, 61, formerly of Pasadena, schemed to defraud Medicare by submitting nearly $4 million in false and fraudulent claims for hospice services submitted by two hospice companies: Arcadia Hospice Provider Inc., and Saint Mariam Hospice Inc. Antenor controlled both companies. Contreras falsely stated on claims forms that patients had terminal illnesses to make them eligible for hospice services covered by Medicare, typically adopting diagnoses provided to him by hospice employees whether or not they were true. Contreras did so even though he was not the patients’ primary care physician and had not spoken to those primary care physicians about the patients’ conditions. Medicare paid on the claims supported by Contreras’ false evaluations and certifications and recertifications of patients. In total, approximately $3,917,946 in fraudulent claims were submitted to Medicare, of which a total of approximately $3,289,889 was paid.
