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2 arrested in alleged $30-million California hospice fraud scheme

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LA Times Today: Fraud in booming hospice industry

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A Ventura County doctor and a marketer from Lancaster were arrested Tuesday on suspicion of carrying out a hospice fraud scheme that netted more than $30 million from Medicare, federal authorities said.

Dr. Victor Contreras, 66, of Santa Paula, and Callie Jean Black, 63, of Lancaster were arraigned Tuesday and pleaded not guilty, said Thom Mrozek, a spokesman for the U.S. attorney’s office for the Central District of California.

Contreras was released on $25,000 bond and Black was released on $10,000 bond, Mrozek said.

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A third defendant — 59-year-old Juanita Antenor, formerly of Pasadena — remains at large and is believed to be in the Philippines, prosecutors said.

Antenor owned the Pasadena hospice company Arcadia Hospice Provider Inc., according to court documents, and controlled a second company called Saint Mariam Hospice Inc.

The companies allegedly billed Medicare and Medi-Cal for hospice services for patients who were not terminally ill, according to court documents, and in some cases submitted bills for services that weren’t provided.

Nowhere has the hospice industry’s growth been more explosive, and its harmful side effects more evident, than in Los Angeles County.

Dec. 9, 2020

According to the indictment, Contreras was on probation imposed by the Medical Board of California while he was part of the scheme. He is accused of providing fraudulent certifications for some patients, including some he claimed to have examined but never actually saw, according to the indictment.

Antenor paid illegal kickbacks to marketers, including Black, for patients referred to the two hospice companies, prosecutors allege.

The allegations mirror the type of widespread hospice fraud outlined in a 2020 Times investigation into the industry’s explosive, largely unchecked growth. California lawmakers said that investigation was a major factor in a moratorium on new state hospice licenses that took effect Jan. 1 along with reform measures.

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Results of a state audit meant to spur improvements to licensing and oversight in end-of-life care are expected to be released this month.

From roughly September 2014 to April 2019, Arcadia Hospice Provider Inc. submitted nearly $23 million in claims to Medicare for hospice services and was paid about $18.85 million, according to the indictment.

Saint Mariam Hospice Inc. submitted Medicare claims totaling about $13.74 million between February 2015 and April 2019 and was paid about $11.39 million.

Contreras was linked to about $5.1 million of the total Medicare claims paid out, prosecutors said.

Allegations including bogus terminal illness diagnoses and illegal kickbacks for patient referrals mirror widespread fraud detailed in a 2020 Times investigation.

Feb. 24, 2022

“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,” prosecutors said.

Antenor was charged with six counts of healthcare fraud and four counts of paying illegal kickbacks for healthcare referrals, prosecutors said. Contreras was charged with five counts of healthcare fraud, and Black was charged with four counts of receiving illegal kickbacks.

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If convicted as charged, Contreras would face a statutory maximum of 50 years in federal prison and Black would face up to 40 years in federal prison, prosecutors said.

A possible sentence was not provided for Antenor.

“A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors,” prosecutors said.

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