NEED TO KNOW
- A Texas doctor, who was found guilty of orchestrating a $118 million medical fraud scheme for his own financial gain, was sentenced to 10 years in federal prison on May 21
- Dr. Jorge Zamora-Quezada falsely diagnosed his patients with illnesses such as rheumatoid arthritis and billed their insurance companies for procedures and tests they did not need
- He is also being forced to forfeit about $28 million, including 13 real estate properties, a jet and a Maserati sports car
A Texas doctor, who was found guilty of fraud for falsely diagnosing patients with diseases they did not have, has been sentenced to 10 years in federal prison.
According to a press release from the U.S. Department of Justice’s Office of Public Affairs, Dr. Jorge Zamora-Quezada was sentenced on May 21 to 10 years in prison and three years of supervised release for his role in a health care fraud scheme that involved more than $118 million in false claims and the payment of more than $28 million by insurers.
During Zamora-Quezada’s Texas trial, prosecutors said he falsely diagnosed his patients with illnesses and billed their insurance companies for procedures and tests they did not need for his own financial gain.
Following his sentencing, Zamora-Quezada, 68, is also being forced to forfeit about $28 million, including 13 real estate properties, a jet and a Maserati GranTurismo sports car.
“Zamora-Quezada falsely diagnosed his patients with rheumatoid arthritis and administered toxic medications in order to defraud Medicare, Medicaid, TRICARE and Blue Cross Blue Shield,” the press release stated. “The fraudulent diagnoses made the defendant’s patients believe that they had a lifelong, incurable condition that required regular treatment at his offices.”
“After falsely diagnosing his patients, Zamora-Quezada administered unnecessary treatments and ordered unnecessary testing on them, including a variety of injections, infusions, X-rays, MRIs and other procedures — all with potentially harmful and even deadly side effects,” the press release continued. “To receive payment for these expensive services, Zamora-Quezada fabricated medical records and lied about the patients’ condition to insurers.”
According to the DOJ, Zamora-Quezada was a rheumatologist who was licensed to practice medicine in Texas, Arizona and Massachusetts. All of his medical licenses have since been revoked.
Prosecutors also argued that Zamora-Quezada attempted to cover up the fraud and “falsified patient records to support the false diagnoses after receiving a federal grand jury subpoena.” His scheme lasted nearly 20 years and involved about $325 million, the DOJ previously said.
Zamora-Quezada was found guilty on one count of conspiracy to commit health care fraud, seven counts of health care fraud and one count of conspiracy to obstruct justice in 2020.
Local outlet KRGV reported that his sentencing was delayed several times because prosecutors and Zamora-Quezada’s defense attorneys could not agree on a number of victims in the scheme or agree on the amount of money that was stolen.
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Zamora-Quezada was also accused of creating a toxic environment for his clinic’s employees — many of whom were on work visas to live in the U.S. — by getting angry if they did not meet a quota for procedures or saying that he would fire them and try to revoke their visa if they spoke out against him.
“Testimony at trial established that Zamora-Quezada told employees to ‘aparecer’ the missing records — ‘to make them appear,’ ” the DOJ said. “Former employees also recounted being sent to a dilapidated barn to attempt to retrieve records. There, files were saturated with feces and urine, rodents and termites that infested not only the records but also the structure.”
According to the DOJ, other rheumatologists in Texas’ Rio Grande Valley region testified during Zamora-Quezada’s 2020 trial that they saw hundreds of patients whom he had falsely diagnosed with rheumatoid arthritis. One doctor even testified that it would be “obvious” to “most” doctors that these patients did not have the autoimmune condition.
Prosecutors also argued that the false diagnoses and medications that Zamora-Quezada prescribed to patients caused “debilitating” side effects, including strokes, necrosis (or cell and tissue death) of the jawbone, hair loss, liver damage and severe pain.
“Constantly being in bed and being unable to get up from bed alone, and being pumped with medication, I didn’t feel like my life had any meaning,” one patient testified during the trial, per the DOJ.
Another patient’s mother testified that she felt like her child served as a “lab rat,” and other patients testified that they were “living a life in the body of an elderly person.”
“Dr. Zamora-Quezada funded his luxurious lifestyle for two decades by traumatizing his patients, abusing his employees, lying to insurers and stealing taxpayer money,” Matthew R. Galeotti, the head of the DOJ’s criminal division, said in the press release.
“His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctor,” Galeotti added.
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