Texas Doctor Found Guilty Of Healthcare Scheme Involving False Diagnosis
A federal jury found a Texas rheumatologist guilty for his role in a $325 million health care fraud scheme in which he falsely diagnosed patients with lifelong diseases and treated them with toxic medications. Jorge 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.
According to the Department of Justice (DOJ) release, Zamora-Quezada diagnosed a large number of patients with rheumatoid arthritis--a lifelong, incurable disease--despite knowing the patients did not have the ailments. Zamora-Quezada then treated the individuals with toxic, medically unnecessary medication like chemotherapy drugs on the basis of the false diagnosis.
The DOJ reports that many of these patients, including some as young as 13, suffered physical and emotional harm as a result of the false diagnosis and unnecessary medical treatments.
In an attempt to “obstruct and mislead” federal grand jury investigations against himself, Zamora-Quezada also falsified medical records. Zamora-Quezada forced his patients to engage in excessive, repetitive, and profit-driven medical procedures under the guise of treating their false ailments.
“The guilty verdict against Dr. Zamora-Quezada ensures he will pay a steep price for his unthinkably callous and cruel criminal conduct, committed for the sheer sake of greed,” said Special Agent in Charge CJ Porter of the Office of Inspector General for the U.S. Department of Health and Human Services (HHS-OIG). “The abhorrent conduct in this case, which resulted in harm to unsuspecting patients, only serves to deepen the dedication of HHS-OIG agents and our law enforcement partners to pursue, prosecute, and exclude bad actors in the Medicare and Medicaid programs.”
Zamora-Quezada operated medical practices throughout South Texas and San Antonio. He traveled to his various offices on his private jet and in his Maserati.
The Rio Grande Valley Health Care Fraud Task Force, which includes the FBI, HHS-OIG, Texas HHS-OIG and Texas Medicaid Fraud Control Unit, investigated the case with assistance from the Defense Criminal Investigative Service.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
TAKEDOWN UPDATE: In July, FEDagent reported on a Florida couple taken down by the U.S. Fish and Wildlife Service on charges related to smuggling Indonesian wildlife to their home in Florida for resale. In a plea agreement announced this week, the couple admitted to the charges against them and agreed to forfeit the wildlife seized from their home. Sentencing has not yet been scheduled.