A California-based physician was recently arrested after pleading guilty to charges of healthcare fraud.
Dr. Sanjoy Banerjee, was a medical director for Fountain Hospice, based in Los
Angeles. Two other medical directors at the hospice, Luis Artavia and Mark Samonte, also face charges for their alleged involvement in a fraud scheme that bilked more than $3.2 million in Medicare and Medi-Cal funds.
The case centers around violations of false or fraudulent claims and conspiracy to commit a crime, with an aggravated white-collar enhancement. Seven individuals were previously arrested in February for their alleged involvement in the case. The individuals allegedly submitted false claims between April 1, 2016 and June 1, 2024, according to court documents.
“Claims that California is overrun with fraud and doing nothing about it are simply false. This case proves it,” Attorney General Bonta said in a statement at the time. “Abusing systems meant to support Californians, and putting profits before people and their families won’t be tolerated — and it won’t fly under the radar. To those committing fraud: we’re watching, we’re investigating, and we’ll act.”
The Monterey County Superior Court in California recently ordered Banerjee to pay restitution of nearly $1.44 million, according to a recent local news report. He allegedly certified patients for hospice care who were not eligible, often without their knowledge. Patients’ beneficiary information was obtained from Medicare and Medi-Cal reimbursement claims. The individuals were later denied hospice care when they attempted to receive these services at the end of life, according to the local news report.
Banerjee served as a primary care clinician at Ocean Breeze Multi-Specialty Clinic. Based in Gonzales, California, the clinic shared a location with home-based care company Art of Palliative Care.
Flor Zulema Mora, CEO and owner of Ocean Breeze Multi-Specialty Clinic, also faces fraud charges. The owner of Compassionate Touch Hospice Inc. and Spiritual Touch Hospice was previously arrested, along with two co-owners of Fountain Hospice and one nurse, Nimfa Molina.
The case was investigated by the Department of Medi-Cal Fraud & Elder Abuse (DMFEA), a division of the California Department of Justice.
Companies featured in this article:
Compassionate Touch Hospice, Fountain Hospice, Ocean Breeze Multi-Specialty Clinic, Spiritual Touch Hospice
