A Monterey doctor is sentenced for his role in a larger $3.2 million hospice fraud scheme.

Dr. Shomir Banerjee did not appear nervous as he sat in Monterey County Superior Court in Salinas on Thursday, July 2, dressed in a blue button-down shirt and khaki pants, awaiting his sentencing hearing. Banerjee was arrested on felony charges in February for his role in a $3.2 million hospice fraud scheme, but quickly admitted guilt to the California Department of Justice in hopes of securing probation instead of prison time.

Listed as a concierge doctor in Monterey and as a physician for a Gonzales medical clinic, Banerjee was not a leader in the fraud conspiracy, but rather a physician hired as a medical director to certify patients for end-of-life care from a hospice service, Fountain Hospice, based in Los Angeles County.

Instead of approving qualified patients, Banerjee and two other physicians, were certifying people who did not need the care, and in many cases did not know their identities were being used.

In addition to defrauding federal and state governments by illegally collecting Medicare and Medi-Cal reimbursements, the defendants harmed people who were signed up – when they attempted to use their benefits they were denied because they were listed as hospice patients, investigators found. Authorities discovered some people were enrolled in hospice care for years and were transferred between the three companies to escape detection.

In court on July 2, California Deputy Attorney General Bianca Yip told Monterey County Superior Court Judge Andrew Liu that Banerjee approached officials soon after the arrest, acknowledging culpability. He originally was facing 30 felony charges, later negotiated down to one: health care fraud.

“Unlike the [hospice facility owners], he got a stipend. He did not share in the profits,” Yip said. “The state believes he is less culpable.”

Banerjee received two years of mandatory supervision instead of a possible five-year prison term and an order to pay restitution: $679,207 for Medi-Cal fraud and $758,797 for Medicare fraud.

Liu ruled during an earlier hearing on May 27 that Banerjee is also prohibited from engaging in any hospice care businesses and from directly billing Medicare or Medi-Cal. Liu rejected the State’s request that Banerjee be prohibited from practicing medicine, arguing it was overbroad.

The case against one of two hospice owners, Flor Zulema Mora, is ongoing in Monterey County Superior Court. Mora is listed as the owner of the Gonzales clinic where Banerjee is also listed as a physician, Ocean Breeze Multi-Speciality Clinic. It shares an address with another company, The Art of Palliative Care. Both are no longer operating, according to Mora, who answered the phone for the palliative care company.

“I didn’t commit fraud. If anything, we’ve given a lot of free services to the community,” she says. “I’ve been dragged into this mess by my business partners.” Mora says she feels Banerjee “is innocent as well.”