HOUSTON (WKRC) – A rheumatologist was caught defrauding Medicare and Medicaid by falsely diagnosing people, performing chemotherapy on healthy patients and prescribing unnecessary drugs that caused harm, among other things.
Jorge Zamora-Quezada, 68, has been sentenced to 10 years in prison and three years of supervised release for orchestrating a health care fraud scheme involving over $118 million in false claims. The scheme led to insurers paying over $28 million after Zamora-Quezada falsely diagnosed patients with chronic illnesses to bill for unnecessary tests and treatments, according to the Department of Justice.
Following a 25-day trial, Zamora-Quezada was convicted of one count of conspiracy to commit health care fraud, seven counts of health care fraud and one count of conspiracy to obstruct justice. In addition to his prison sentence, he was ordered to forfeit $28,245,454, including 13 real estate properties, a jet and a Maserati GranTurismo.
Evidence presented at trial revealed that Zamora-Quezada falsely diagnosed patients with rheumatoid arthritis and administered toxic medications to defraud Medicare, Medicaid, TRICARE and Blue Cross Blue Shield. His fraudulent diagnoses led patients to believe they had a lifelong, incurable condition requiring regular treatment at his offices.
Zamora-Quezada then administered unnecessary treatments and ordered unnecessary testing, including injections, infusions, x-rays, MRIs and other procedures, all with potentially harmful side effects.
“Dr. Zamora-Quezada funded his luxurious lifestyle for two decades by traumatizing his patients, abusing his employees, lying to insurers, and stealing taxpayer money,” said Matthew R. Galeotti, Head of the Justice Department’s Criminal Division. “His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctors.”
The FBI’s San Antonio Field Office Special Agent in Charge Aaron Tapp added, “This case was not only a concern to us because of the financial loss — the physical and emotional harm suffered by the patients and their families was alarming and profound.”
Testimony at trial revealed that other rheumatologists in the Rio Grande Valley saw hundreds of patients previously diagnosed with rheumatoid arthritis by Zamora-Quezada who did not have the condition. One physician noted that for “most” it was “obvious that the patient did not have rheumatoid arthritis.”
Zamora-Quezada’s false diagnoses and powerful medications caused debilitating side effects, including strokes, necrosis of the jawbone, hair loss, liver damage and severe pain. One patient testified, “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.”
