


A doctor who worked for two Pasadena hospices was sentenced to two years in federal prison on Monday after pleading guilty to health care fraud.
Authorities say 69-year-old Dr. Victor Contreras of Santa Paula defrauded Medicare out of more than $3.2 million by submitting false and fraudulent claims for hospice care, stating that patients had terminal illnesses that would warrant the care regardless of whether that was true.
During a nearly three-year period from 2016 to 2019, Contreras worked with a co-defendant to submit the false claims for hospice services by Arcadia Hospice Provider Inc. and St. Mariam Hospice Inc., two companies that the co-defendant controlled, according to a Department of Justice news release.
“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,” the release stated.
Medicare provides hospice services only in cases where patients are considered terminally ill, meaning they are expected to live for six months or less with the typical progression of their illness.
Contreras would make these claims, supported by false evaluations, certifications and recertifications of patients, despite not being their primary care physician and without ever speaking to their primary care physicians, the DOJ stated.
The fraud scheme resulted in $3,917,946 of fraudulent claims submitted to Medicare in total. About $3,289,889 was paid out.
The DOJ noted that though Contreras is a licensed physician with the Medical Board of California, he has been on probation since 2015, which subjects him to “limitations on his practice.”
Monday’s sentencing came after Contreras pleaded guilty to the health care fraud charge over the summer. In addition to prison time, a judge ordered him to pay $3,289,889 in restitution.
Another co-defendant in the matter, who authorities suspect of recruiting patients for the scheme in exchange for “illegal kickbacks,” according to the DOJ, is scheduled to go to trial in March. The co-defendant who controlled the hospice companies remains “at large,” according to authorities.