LOS ANGELES, California (Grimy Times) – A physician and a patient recruiter have been arrested in a massive Medicare scam that bilked the program out of over $30 million.
Dr. Victor Contreras, 66, of Santa Paula, and Callie Jean Black, 63, of Lancaster, were scheduled to be arraigned this afternoon in United States District Court.
The pair is accused of participating in a scheme that provided medically unnecessary hospice services to patients who were obtained through illegal kickbacks, according to court documents.
The indictment names the former Pasadena resident who controlled the hospices, Juanita Antenor, 59, who remains at large and is believed to be in the Philippines.
Antenor allegedly owned a Pasadena hospice company called Arcadia Hospice Provider, Inc., and controlled a second, Saint Mariam Hospice, Inc., that billed Medicare and Medi-Cal for hospice services for patients who were not terminally ill.
Contreras, who was on probation imposed by the California Medical Board while he was part of the scheme, provided fraudulent certifications for some of these patients, including patients he claimed to have examined, but never actually saw, according to the indictment.
Antenor allegedly paid marketers, including Black, illegal kickbacks for the patients referred to Arcadia and Saint Mariam.
From approximately September 2014 until April 2019, Arcadia submitted to Medicare nearly $23 million in claims for hospice services provided to beneficiaries and was paid approximately $18,853,757 for those claims, according to the indictment. Between February 2015 and April 2019, St. Mariam submitted to Medicare approximately $13,742,116 in claims for hospice services and was paid approximately $11,395,849 for those claims.
Additionally, Arcadia and St. Mariam submitted more than $5.5 million in claims to Medi-Cal, which paid the companies a total of just over $1.35 million.
Antenor and Contreras are charged in the indictment with health care fraud – six counts name Antenor, and Contreras is charged with five counts. Additionally, Antenor is charged with four counts of paying illegal kickbacks for health care referrals, and Black is charged with four counts of receiving illegal kickbacks.
An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proved guilty beyond a reasonable doubt.
If convicted of the charges in the indictment, Contreras would face a statutory maximum sentence of 50 years in prison, while Black would face up to 40 years. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
The United States Department of Health and Human Services, Office of the Inspector General; the FBI; and California Department of Justice investigated this matter.
Assistant United States Attorney Kristen A. Williams of the Major Frauds Section is prosecuting this case.
Defendant: Dr. Victor Contreras
Criminal Charges: health care fraud, paying illegal kickbacks for health care referrals
City, State: Los Angeles, California
Date: (no specific date mentioned)
Sentence: 50 years in prison
Dollar Amounts: over $30 million
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Key Facts
- State: California
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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