A Texas doctor, rheumatologist Jorge Zamora-Quezada, the man who defrauded insurance companies by issuing false diagnoses to patients, has been sentenced to 10 years in prison. In total, his scheme involved $118 million in false claims, defrauding $28 million from insurance companies.
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According to a press release issued by the U.S. Department of Justice’s Office of Public Affairs, Zamora-Quezada was found guilty of one count of conspiracy to commit health care fraud, seven counts of healthcare fraud, and one count of conspiracy to obstruct justice.
Zamora-Quezada managed to defraud a multitude of insurance companies by falsely diagnosing his patients with rheumatoid arthritis. These include Medicare, Medicaid, TRICARE, and Blue Cross Blue Shield.
He would administer “toxic medications” and make his patients believe they had the disease, which lasts for life and is incurable. That way, his patients were treated continuously at his offices.
To further expand his fraudulent scheme, Zamora-Quezada fabricated medical records. That way, he could effectively lie to his patients’ insurers by claiming they were sick with the aforementioned disease. As previously stated, he managed to secure $118 million in false claims and defrauded $28 million from insurance companies.
‘Unnecessary Treatments’
Following his faux diagnoses, Zamora-Quezada administered “unnecessary treatments” and even ordered equally unnecessary testing. These tests, which included x-rays, MRIs, infusions, and injections, can be fatal due to their potential side effects.
The effects of his reckless and illegal behavior were made evident. Some of his patients suffered serious side effects. These include, but are not limited to, strokes, jawbone necrosis, and liver damage.
“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 in court.
Furthermore, Zamora-Quezada also intimidated and manipulated his employees, referring to himself as “eminencia,” or “eminence” in English. He would intentionally hire employees on J-1 visas to have further control over them, threatening their legal status.
“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, Head of the Justice Department’s Criminal Division, said. “His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctors.”
Jorge Zamora-Quezada was sentenced to 10 years in prison, followed by three years of supervised release. He was ordered to forfeit a total of $28,245,454. In addition, he must forfeit 13 real estate properties, a jet, and a Maserati GranTurismo.