A Ventura County physician, Dr. Victor Contreras, has admitted to defrauding Medicare by billing for unnecessary hospice services. The 68-year-old doctor from Santa Paula pleaded guilty to one count of health care fraud in a case involving more than $3 million.
Dr. Contreras worked with co-defendant Juanita Antenor, formerly of Pasadena, from July 2016 to February 2019. They submitted nearly $4 million in false claims through two companies controlled by Antenor: Arcadia Hospice Provider Inc., and Saint Mariam Hospice Inc.
Medicare provides coverage for hospice services only for terminally ill patients with a life expectancy of six months or less. However, Contreras falsely certified that patients were terminally ill based on diagnoses given by hospice employees without verifying the information with primary care physicians.
The fraudulent claims amounted to approximately $3,917,946, with Medicare paying around $3,289,889 based on these falsified evaluations and certifications.
According to the Medical Board of California records, Dr. Contreras is licensed but has been under probation since 2015 with certain practice limitations.
United States District Judge André Birotte Jr. has set an October 25 sentencing date for Dr. Contreras who could face up to 10 years in federal prison.
Meanwhile, Juanita Antenor remains at large. Another co-defendant, Callie Black from Lancaster—accused of recruiting patients for kickbacks—has pleaded not guilty and is set for trial on October 15.
The investigation was conducted by the United States Department of Health and Human Services Office of Inspector General, the FBI, and the California Department of Justice. Assistant United States Attorneys Kristen A. Williams and Aylin Kuzucan are prosecuting this case.
