Office of Public Affairs Texas Doctor Who Falsely Diagnosed Patients Sentenced to 10 Years Imprisonment in Connection with 118M in Fraudulent Health Care Claims United States Department of Justice
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ppArchived NewsppA Texas rheumatologist was sentenced to 10 years in prison and three years of supervised release for perpetrating a health care fraud scheme involving over 118 million in false claims and the payment of over 28 million by insurers as a result of him falsely diagnosing patients with chronic illnesses to bill for tests and treatments that the patients did not need Jorge ZamoraQuezada MD 68 of Mission also falsified patient records to support the false diagnoses after receiving a federal grand jury subpoena Following a 25day trial ZamoraQuezada 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 In addition to his prison term ZamoraQuezada was ordered to forfeit 28245454 including 13 real estate properties a jet and a Maserati GranTurismoppAccording to the evidence presented at trial ZamoraQuezada falsely diagnosed his patients with rheumatoid arthritis and administered toxic medications in order to defraud Medicare Medicaid TRICARE and Blue Cross Blue Shield The fraudulent diagnoses made the defendants patients believe that they had a lifelong incurable condition that required regular treatment at his offices After falsely diagnosing his patients ZamoraQuezada administered unnecessary treatments and ordered unnecessary testing on them including a variety of injections infusions xrays MRIs and other proceduresall with potentially harmful and even deadly side effects To receive payment for these expensive services ZamoraQuezada fabricated medical records and lied about the patients condition to insurersppDr ZamoraQuezada funded his luxurious lifestyle for two decades by traumatizing his patients abusing his employees lying to insurers and stealing taxpayer money said Matthew R Galeotti Head of the Justice Departments Criminal Division His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctors Todays sentence is not just a punishmentits a warning Medical professionals who harm Americans for personal enrichment will be aggressively pursued and held accountable to protect our citizens and the public fiscppThrough the false diagnoses and excessive false billing Dr ZamoraQuezada abused both patient trust and public resources said Special Agent in Charge Jason E Meadows of the US Department of Health and Human Services Office of Inspector General HHSOIG It is imperative to investigate and address this form of fraud not only to protect vulnerable individuals from harm but to uphold the integrity of the federal health care system and safeguard the use of public fundsppThe FBI is dedicated to working with all of our partners to address health care fraud said Special Agent in Charge Aaron Tapp of the FBIs San Antonio Field Office This case was not only a concern to us because of the financial loss the physical and emotional harm suffered by the patients and their families was alarming and profound We hope this significant sentence will help bring closure to the many victims in this caseppEvidence at trial established that Dr ZamoraQuezada falsely diagnosed patients in order to defraud insurers and enrich himself Other rheumatologists in the Rio Grande Valley testified at trial that they saw hundreds of patients previously diagnosed with rheumatoid arthritis by ZamoraQuezada who did not have the condition prompting one physician to explain that for most it was obvious that the patient did not have rheumatoid arthritis ZamoraQuezadas false diagnoses and powerful medications caused debilitating side effects on his patients including strokes necrosis of the jawbone hair loss liver damage and pain so severe that basic tasks of everyday life such as bathing cooking and driving became difficult As one patient testified Constantly being in bed and being unable to get up from bed alone and being pumped with medication I didnt feel like my life had any meaning One mother described how she felt that her child served as a lab rat and others described abandoning plans for college or feeling like they were living a life in the body of an elderly personppFormer employees detailed how ZamoraQuezada imposed strict quotas for procedures leading to a climate of fear ZamoraQuezada referred to himself as the eminencia or eminence threw a paperweight at an employee who failed to generate enough unnecessary procedures hired employees he could manipulate because they were on J1 visas and their immigration status could be jeopardized if they lost their jobs and fired those who challenged him Testimony also revealed ZamoraQuezadas obstruction of insurer audits by fabricating missing patient files including by taking ultrasounds of employees and using those images as documentation in the patient records Testimony at trial established that ZamoraQuezada told employees to aparecer the missing records to make them appear Former employees also recounted being sent to a dilapidated barn to attempt to retrieve records There files were saturated with feces and urine rodents and termites that infested not only the records but also the structureppZamoraQuezada used proceeds from his crimes to fund a lavish lifestyle replete with real estate properties across the country and in Mexico a jet and a MaseratippFBI HHSOIG Texas HHSOIG and the Texas Medicaid Fraud Control Unit investigated the case with assistance from the Defense Criminal Investigative ServiceppPrincipal Assistant Chief Jacob Foster and Assistant Chiefs Rebecca Yuan and Emily Gurskis of the Criminal Divisions Fraud Section and Assistant US Attorney Laura Garcia for the Southern District of Texas prosecuted the case Assistant US Attorney Kristine Rollinson handled asset forfeiture Fraud Section Assistant Chief Kevin Lowell initially handled the prosecution The prosecution team thanks the Fraud Sections Data Analytics Team whose work initiated the investigation Victim Witness Specialist Olga De La Rosa of the US Attorneys Office for the Southern District of Texas and the Texas Department of InsuranceppThe Fraud Section leads the Criminal Divisions efforts to combat health care fraud through the Health Care Fraud Strike Force Program Since March 2007 this program currently comprised of nine strike forces operating in 27 federal districts has charged more than 5800 defendants who collectively have billed federal health care programs and private insurers more than 30 billion In addition the Centers for Medicare Medicaid Services working in conjunction with HHSOIG are taking steps to hold providers accountable for their involvement in health care fraud schemes More information can be found at wwwjusticegovcriminalfraudhealthcarefraudunitppA federal jury convicted the CEO of Power Mobility Doctor Rx LLC DMERx for his role in operating a platform that generated false doctors orders to defraud Medicare and otherppA Missouri man pleaded guilty today to orchestrating a scheme to defraud Medicare by unlawfully billing millions of dollars in claims for cancer genetic testing and cardiovascular genetic testingppTwo indictments were unsealed today charging a South Carolina man with defrauding Medicare through a laboratory test scheme during the COVID19 pandemic and with defrauding customers of his private charterppOffice of Public AffairsUS Department of Justice950 Pennsylvania Avenue NWWashington DC 20530ppOffice of Public Affairs Direct Line2025142007ppDepartment of Justice Main Switchboard2025142000ppSignup for Email UpdatesSocial MediappppHave a question about Government Servicesp
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Lock
Locked padlock
or https means youve safely connected to the gov website Share sensitive information only on official secure websites
ppArchived NewsppA Texas rheumatologist was sentenced to 10 years in prison and three years of supervised release for perpetrating a health care fraud scheme involving over 118 million in false claims and the payment of over 28 million by insurers as a result of him falsely diagnosing patients with chronic illnesses to bill for tests and treatments that the patients did not need Jorge ZamoraQuezada MD 68 of Mission also falsified patient records to support the false diagnoses after receiving a federal grand jury subpoena Following a 25day trial ZamoraQuezada 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 In addition to his prison term ZamoraQuezada was ordered to forfeit 28245454 including 13 real estate properties a jet and a Maserati GranTurismoppAccording to the evidence presented at trial ZamoraQuezada falsely diagnosed his patients with rheumatoid arthritis and administered toxic medications in order to defraud Medicare Medicaid TRICARE and Blue Cross Blue Shield The fraudulent diagnoses made the defendants patients believe that they had a lifelong incurable condition that required regular treatment at his offices After falsely diagnosing his patients ZamoraQuezada administered unnecessary treatments and ordered unnecessary testing on them including a variety of injections infusions xrays MRIs and other proceduresall with potentially harmful and even deadly side effects To receive payment for these expensive services ZamoraQuezada fabricated medical records and lied about the patients condition to insurersppDr ZamoraQuezada funded his luxurious lifestyle for two decades by traumatizing his patients abusing his employees lying to insurers and stealing taxpayer money said Matthew R Galeotti Head of the Justice Departments Criminal Division His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctors Todays sentence is not just a punishmentits a warning Medical professionals who harm Americans for personal enrichment will be aggressively pursued and held accountable to protect our citizens and the public fiscppThrough the false diagnoses and excessive false billing Dr ZamoraQuezada abused both patient trust and public resources said Special Agent in Charge Jason E Meadows of the US Department of Health and Human Services Office of Inspector General HHSOIG It is imperative to investigate and address this form of fraud not only to protect vulnerable individuals from harm but to uphold the integrity of the federal health care system and safeguard the use of public fundsppThe FBI is dedicated to working with all of our partners to address health care fraud said Special Agent in Charge Aaron Tapp of the FBIs San Antonio Field Office This case was not only a concern to us because of the financial loss the physical and emotional harm suffered by the patients and their families was alarming and profound We hope this significant sentence will help bring closure to the many victims in this caseppEvidence at trial established that Dr ZamoraQuezada falsely diagnosed patients in order to defraud insurers and enrich himself Other rheumatologists in the Rio Grande Valley testified at trial that they saw hundreds of patients previously diagnosed with rheumatoid arthritis by ZamoraQuezada who did not have the condition prompting one physician to explain that for most it was obvious that the patient did not have rheumatoid arthritis ZamoraQuezadas false diagnoses and powerful medications caused debilitating side effects on his patients including strokes necrosis of the jawbone hair loss liver damage and pain so severe that basic tasks of everyday life such as bathing cooking and driving became difficult As one patient testified Constantly being in bed and being unable to get up from bed alone and being pumped with medication I didnt feel like my life had any meaning One mother described how she felt that her child served as a lab rat and others described abandoning plans for college or feeling like they were living a life in the body of an elderly personppFormer employees detailed how ZamoraQuezada imposed strict quotas for procedures leading to a climate of fear ZamoraQuezada referred to himself as the eminencia or eminence threw a paperweight at an employee who failed to generate enough unnecessary procedures hired employees he could manipulate because they were on J1 visas and their immigration status could be jeopardized if they lost their jobs and fired those who challenged him Testimony also revealed ZamoraQuezadas obstruction of insurer audits by fabricating missing patient files including by taking ultrasounds of employees and using those images as documentation in the patient records Testimony at trial established that ZamoraQuezada told employees to aparecer the missing records to make them appear Former employees also recounted being sent to a dilapidated barn to attempt to retrieve records There files were saturated with feces and urine rodents and termites that infested not only the records but also the structureppZamoraQuezada used proceeds from his crimes to fund a lavish lifestyle replete with real estate properties across the country and in Mexico a jet and a MaseratippFBI HHSOIG Texas HHSOIG and the Texas Medicaid Fraud Control Unit investigated the case with assistance from the Defense Criminal Investigative ServiceppPrincipal Assistant Chief Jacob Foster and Assistant Chiefs Rebecca Yuan and Emily Gurskis of the Criminal Divisions Fraud Section and Assistant US Attorney Laura Garcia for the Southern District of Texas prosecuted the case Assistant US Attorney Kristine Rollinson handled asset forfeiture Fraud Section Assistant Chief Kevin Lowell initially handled the prosecution The prosecution team thanks the Fraud Sections Data Analytics Team whose work initiated the investigation Victim Witness Specialist Olga De La Rosa of the US Attorneys Office for the Southern District of Texas and the Texas Department of InsuranceppThe Fraud Section leads the Criminal Divisions efforts to combat health care fraud through the Health Care Fraud Strike Force Program Since March 2007 this program currently comprised of nine strike forces operating in 27 federal districts has charged more than 5800 defendants who collectively have billed federal health care programs and private insurers more than 30 billion In addition the Centers for Medicare Medicaid Services working in conjunction with HHSOIG are taking steps to hold providers accountable for their involvement in health care fraud schemes More information can be found at wwwjusticegovcriminalfraudhealthcarefraudunitppA federal jury convicted the CEO of Power Mobility Doctor Rx LLC DMERx for his role in operating a platform that generated false doctors orders to defraud Medicare and otherppA Missouri man pleaded guilty today to orchestrating a scheme to defraud Medicare by unlawfully billing millions of dollars in claims for cancer genetic testing and cardiovascular genetic testingppTwo indictments were unsealed today charging a South Carolina man with defrauding Medicare through a laboratory test scheme during the COVID19 pandemic and with defrauding customers of his private charterppOffice of Public AffairsUS Department of Justice950 Pennsylvania Avenue NWWashington DC 20530ppOffice of Public Affairs Direct Line2025142007ppDepartment of Justice Main Switchboard2025142000ppSignup for Email UpdatesSocial MediappppHave a question about Government Servicesp
