That’s Jorge Zamora-Quezada M.D., 68, of Mission, Texas above, who was sentenced this week tten years in prison and three years of supervised release for perpetrating a health care fraud scheme involving over $118 million in false claims. More than $28 million was paid out by insurers because he falsely diagnosed patients with chronic illnesses to bill them for tests and treatments that the patients did not need. Zamora-Quezada also falsified patient records to support the false diagnoses.
Yikes.
The Justice Department press release reveals that 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. His patients were told that they had incurable conditions that required regular treatment at his offices, where Zamora-Quezada administered unnecessary drugs and ordered unnecessary testing. These included injections, infusions, x-rays, MRIs, and other procedures, risking harmful and in some cases deadly side effects. Then the doctor fabricated medical records and lied about the patients’ condition to insurers.
Among the debilitating side effects suffered by his patients were strokes, necrosis of the jawbone, hair loss, liver damage, and crippling, chronic 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. Others described abandoning plans for college or feeling like they were “living a life in the body of an elderly person.”
At trial, the more ethical rheumatologists in the Rio Grande Valley testified that they saw hundreds of patients diagnosed with rheumatoid arthritis by Zamora-Quezada that did not in fact have the condition. Meanwhile, he was an abusive, dominating supervisor to his medical staff. Former employees said Zamora-Quezada imposed strict quotas for procedures. He threw a paperweight at one employee who failed to generate enough unnecessary procedures, hired staff he could manipulate because they were on J-1 visas and knew their immigration status could be jeopardized if they lost their jobs. Zamora-Quezada also took ultrasounds of employees and used those images to falsify patient records.
Following a 25-day trial, a jury convicted Dr. Zamora-Quezada of one count of conspiracy to commit health care fraud, seven counts of health care fraud, and one count of conspiracy to obstruct justice. To go with his prison term, Zamora-Quezada was ordered to forfeit $28,245,454, including 13 real estate properties, a jet, and a Maserati GranTurismo.
My question: why only ten years in prison for such conduct? He should have been sent away for life.
Ethics Alarms 
Sounds like a decent enough guy. He must not have been that bad if they couldn’t get up to at least 34 felonies.
why did it take 25 day? The first witnesss, the paper trail and pictures of the Maserati should have been presented on day 1. Then the judge could have for a show of hands whether he was an asshole.
There are more than a few things rotten in this scenario.
20 years to nail someone this deep in fraud? Be proud HHS, DOJ, FBI, Medicare, Medicaid, Tricare, Blue Cross Blue Shield.
Rheumatologists testified ar trial, but no indication any stepped up earlier.
Former employees testified at trial, but, no confidential whistle-blowing earlier?
$118 million in fraud, but only 7counts? Medical claims of $15-20 million just don’t seem right to me.
Another DOJ release, dated January 15, 2020, yes 2020, says Zamora was convicted then. So, is the current DOJ trying to take credit for something from 5 years ago, or, was it 5 years to get to sentencing? Oh, and the fraud back in 2020 was stated as $325 million.
Another news article says sentencing was delayed because defense and prosecution lawyers could not agree on the number of victims and extent of damages. Five years? Five years of continued luxurious living for the fraudster? Well, you know, lawyers.
Excellent research, HJ.
I hope that my last comment there (lawyers) does not imply even the slightest possibility of collusion between defense and prosecution because, well, that would be unethical, and, well, there’s not all that much money involved, so I certainly did not intend to imply that, and I hope no one infers it. Besides, there had to be a judge watching over things, right?
This sort of thing is why I believe we need cruel and unusual punishment. Some fates are worse than death, and sometimes you can find someone who deserves such a fate beyond any realistic doubt.
Here’s Johnny raises some incisive points about how many things had to go wrong (and are probably still going wrong) for this to happen. If any of the patients had gone to another doctor to get a second opinion, would the initial misdiagnosis have been reported to any institution inclined to investigate?