A Texas doctor who falsely diagnosed his healthy patients to fund his lavish lifestyle with private jets and luxury sports cars as part of a $118 million health care scheme was sentenced to a decade behind bars.
Rheumatologist Jorge Zamora-Quezada defrauded patients and insurance companies by purposefully diagnosing people with rheumatoid arthritis despite them not having the life-long and incurable condition.
Zamora-Quezada, 68, masterminded the scheme out of his Mission, Texas office with the help of staffers who were abused and threatened by his status, the Department of Justice said.
The disgraced health care provider led patients to believe they were suffering from chronic illnesses and they would pay unnecessary and costly treatments and testing that included a variety of injections, infusions, x-rays, MRIs, and other procedures
The regimens included the administration of toxic medications that had potentially harmful and even deadly side effects.
Zamora-Quezada also falsified medical records of his patients to secure insurance funds from providers by falsifying medical.
He defrauded $28 million from Medicare, Medicaid, TRICARE, and Blue Cross Blue Shield.
Other doctors in the Rio Grande Valley testified against Zamora-Quezada during the 25-day trial, revealing the surprising findings when they treated hundreds of patients, believing they had RA.
“For most (patients) it was obvious that they did not have rheumatoid arthritis,” one rheumatologist testified.
The dangerous treatments Zamora-Quezada prescribed caused patients to develop debilitating side effects, including strokes, necrosis of the jawbone, hair loss and liver damage.
Other victims developed pain so severe that they were left unable to perform simple, everyday tasks.
“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 told the court.
A mother compared her child to a lab rat with the amount of medication Zamora-Quezada prescribed.
The corrupt caregiver used his position to hire foreign staffers who needed employment to remain in the country on their J-1 visas and wouldn’t question his authority unless they risked being fired and deported.
Calling himself “eminencia” — or eminence, Zamora-Quezada built a work atmosphere of fear and authority.
Zamora-Quezada would use his employees as models for ultrasounds that he would include as part of a fabricated missing patients file if he were audited by an insurer.
Thousands of patient files were stored in a separate shed ravaged by rodents and termites — most documents covered in feces and urine.
If he was questioned on missing patients’ records, the doctor would order his staffers to make files “appear.”
Zamora-Quezada used the millions in takings to build an expansive real estate portfolio complete with 13 separate properties in the US and Mexico, purchased a two-engine plane and a Maserati GranTurismo.
“Dr. Zamora-Quezada funded his luxurious lifestyle for two decades by traumatizing his patients, abusing his employees, lying to insurers, and stealing taxpayer money,” the DOJ’s Criminal Division head Matthew R. Galeotti said. “His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctors.”
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.
He was sentenced to 10 years in prison and ordered to forfeit $28,245,454, his real estate portfolio, jet and Maserati.
“Today’s sentence is not just a punishment—it’s a warning. Medical professionals who harm Americans for personal enrichment will be aggressively pursued and held accountable to protect our citizens and the public fisc,” Galeotti said.
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