A rheumatologist from Mission, Texas, was sentenced to 10 years for falsely diagnosing patients with chronic illnesses and billing insurers for more than $118 million in fraudulent claims.
Five things to know:
1. Jorge Zamora-Quezada, MD, 68, falsely diagnosed patients with rheumatoid arthritis and administered toxic medications in order to defraud Medicare, Medicaid, Tricare and Blue Cross Blue Shield, according to a May 21 Justice Department news release.
2. After falsely diagnosing his patients, Dr. Zamora-Quezada administered unnecessary treatments and ordered unnecessary testing, including a variety of injections, infusions, X-rays and MRIs, according to the release.
3. To receive payment for these services, he fabricated medical records and lied about the patients’ conditions to insurers. Insurers paid out more than $28 million to Dr. Zamora-Quezada as a result of the false claims.
4. Dr. Zamora-Quezada was sentenced after being found guilty by a jury of one count of conspiracy to commit health care fraud, seven counts of health care fraud, and one count of conspiracy to obstruct justice.
5. In addition to his prison sentence, he was ordered to forfeit more than $28 million.
