California physician sentenced for $3.2M fraud scheme 

A Santa Paula, Calif., physician has been sentenced to two years for defrauding Medicare of more than $3 million for medically unnecessary claims. 

Advertisement

While working at two different Pasadena-based hospices –– Arcadia Hospice Provider and Saint Mariam Hospice –– Victor Contreras, MD, billed Medicare for medically unnecessary hospice services, according to a Dec. 8 news release from the Justice Department.  

According to the release, Dr. Contreras falsely stated on claim forms that patients had terminal illnesses that would qualify them for Medicare hospice service coverage. He adopted diagnoses provided to him by hospice employees regardless of their validity or without speaking to those patients’ primary care physicians. Medicare paid on Dr. Contreras’ false evaluations and claim submissions. 

Dr. Contreras pleaded guilty on July 24 to one count of healthcare fraud.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

How University Health turns ED signals into hospital-wide flow

Thursday, August 13
1:00 PM - 2:00 PM CDT

Presenters: Bill Phillips, University HealthAshley Schutz, MHA, MLS (ASCP), University HealthBill Griffith

Advertisement

Next Up in Leadership

Advertisement

Comments are closed.