Doc Guilty in 'Heinous' $325M Fraud Case Involving False Diagnoses

Megan Brooks

January 16, 2020

A rheumatologist from Mission, Texas, has been found guilty for his role in a $325 million healthcare fraud scheme in which he falsely diagnosed patients as having rheumatoid arthritis and then treated them with toxic medications.

What 63-year-old Jorge Zamora-Quezada, MD, did was "heinous," Assistant Attorney General Brian Benczkowski, from the Criminal Division of the Department of Justice (DOJ), said in a news release.

Dr Jorge Zamora-Quezada

"Dr Zamora-Quezada falsely diagnosed vulnerable patients, including the young, elderly, and disabled, with lifelong diseases requiring invasive treatments that those patients did not in fact need. [This] guilty verdict shows that the Department of Justice will work tirelessly to protect the public from unscrupulous medical professionals who greedily line their own pockets at the expense of their patients' health and safety," said Benczkowski.

"One of the Worst Medical Fraudsters"

Following a 25-day trial, Zamora-Quezada was convicted of one count of conspiracy to commit healthcare fraud, seven counts of healthcare fraud, and one count of conspiracy to obstruct justice.

According to the evidence presented at trial, Zamora-Quezada falsely diagnosed a large number of patients as having rheumatoid arthritis and treated them with medically unnecessary drugs, including chemotherapy.

Many patients, including those as young as 13 years, suffered physical and emotional harm as a result of the false diagnoses, chemotherapy injections, long sessions of intravenous infusions, and other "excessive, repetitive and profit-driven medical procedures," the DOJ said.

Zamora-Quezada also falsified medical records to obstruct and mislead a federal grand jury investigation. He operated medical practices throughout South Texas and San Antonio and traveled to his various offices on his private jet and in his Maserati.

"As evidenced by the length of trial, this was a massive investigation into one of the worst medical fraudsters," Ryan Patrick, US attorney for the Southern District of Texas, said in the release.

"Unnecessary medical tests to create millions of dollars of false billing is as bad as it gets. Patients were put through unneeded anxiety and pain so the doctor could make millions. He won't need it where he's headed," said Patrick.

"Egregious Case"

"Rarely do we see such an egregious case of healthcare fraud, where so many patients received years of unnecessary and debilitating treatments, which were rendered out of sheer greed," added Christopher Combs, special agent in charge of the FBI's San Antonio Field Office.

Zamora-Quezada is expected to be sentenced on March 27.

Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4200 defendants who have collectively billed the Medicare program for nearly $19 billion, according to the DOJ.

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