Ventura County doctor sentenced to prison for Medicare fraud

December 16, 2024

By KAREN VELIE

A Ventura County physician who worked for two hospices was sentenced today to 24 months in federal prison for defrauding Medicare out of more than $3 million through claims for medically unnecessary hospice services.

U. S. District Judge André Birotte Jr. also ordered Dr. Victor Contreras, 69, to pay $3,289,889 in restitution. Contreras pleaded guilty on July 24 to one count of health care fraud.

From July 2016 to Feb. 2019, Contreras and co-defendant Juanita Antenor, 62, schemed to defraud Medicare. They submitting nearly $4 million in false and fraudulent claims for hospice services for two hospice companies: Arcadia Hospice Provider Inc., and Saint Mariam Hospice Inc. Antenor controlled both companies.

Medicare only covers hospice services for patients who are terminally ill, meaning that they have a life expectancy of six months or less. Contreras falsely reported that patients had terminal illnesses to make them eligible for hospice services covered by Medicare.

Contreras was not the patients’ primary care physician and had not spoken to those physicians about the patients’ conditions. Medicare paid on the claims supported by Contreras’ false evaluations.

In total, approximately $3,917,946 in fraudulently claims were submitted to Medicare.

Contreras is a licensed physician in California, but has been on probation with the Medical Board of California since 2015 and is subject to limitations on his practice.

Antenor remains at large. Co-defendant Callie Black, 66, of Lancaster, who allegedly recruited patients for the hospice companies in exchange for illegal kickbacks, pleaded not guilty and is scheduled to go to trial on March 4.