A California physician and a patient recruiter were charged with bilking Medicare out of more than $36 million, the Justice Department said this week.
Victor Contreras, MD, 66, and Callie Jean Black, 63, were arrested March 8. Another defendant named in the 14-count indictment was Juanita Antenor, 59, who remains at large and is believed to be in the Philippines.
Prosecutors claim that Ms. Antenor owned two hospice companies — Arcadia Hospice Provider and Saint Mariam Hospice — that billed government insurers for medically unnecessary hospice services. Prosecutors allege that the companies submitted bills for services that were never provided or for patients who were not terminally ill.
Of the $36 million in fraudulent billings submitted between 2014 and 2019, Medicare paid $30.2 million. Dr. Contreras is linked to about $5.1 million in the claims paid by Medicare.
Prosecutors said Dr. Contreras allegedly provided fraudulent certifications for some patients, including those he said he examined but never actually saw.
Ms. Black is accused of accepting kickbacks from Ms. Antenor in exchange for referring physicians, a violation of the federal anti-kickback statute.
Dr. Contreras is charged with five counts of healthcare fraud and Ms. Black is charged with four counts of receiving illegal kickbacks. If convicted, Dr. Contreras faces up to 50 years in prison, and Ms. Black faces up to 40 years.