Texas Doctor Scams Patients for Millions—And Health! Will He Pay the Price?

Texas Doctor Sentenced for Health Care Fraud

Dr. Jorge Zamora-Quezada, a rheumatologist from Mission, Texas, was sentenced to 10 years in prison after being convicted of carrying out a health care fraud scheme involving over $118 million in false claims. His fraudulent practices resulted in insurance companies paying out over $28 million for misdiagnosed conditions and unnecessary treatments.

According to court documents, Zamora-Quezada falsely diagnosed numerous patients with rheumatoid arthritis, a chronic autoimmune disease, and then prescribed treatments that were not medically necessary. These treatments included injections, infusions, MRIs, X-rays, and other procedures. He also falsified patient records to support his false diagnoses after receiving a federal grand jury subpoena.

Following a 25-day trial, he was convicted of multiple charges, including conspiracy to commit health care fraud, health care fraud, and conspiracy to obstruct justice. Alongside his prison sentence, Zamora-Quezada was ordered to forfeit assets worth $28 million, including 13 properties, a private jet, and a luxury Maserati GranTurismo.

How the Scheme Worked

Evidence presented at trial showed that Zamora-Quezada’s misdiagnoses led patients to believe they had lifelong illnesses, requiring frequent visits to his clinics for ongoing treatment. This resulted in high medical costs for both patients and insurance providers.

Other rheumatologists in the Rio Grande Valley testified that they examined hundreds of former patients diagnosed by Zamora-Quezada and found many did not actually have rheumatoid arthritis. Some of these patients suffered severe side effects from the unnecessary treatments, including:

• Strokes

• Bone necrosis

• Hair loss

• Liver damage

• Chronic pain that affected daily activities

In addition to misleading patients, Zamora-Quezada enforced strict quotas on his employees, demanding they perform a high number of unnecessary procedures. Investigators also discovered that he obstructed audits by fabricating patient records—even using ultrasounds of employees to fill missing documentation.

One of the most alarming discoveries was how patient records were stored—in a deteriorating barn filled with rodents, termite-infested documents, and unsanitary conditions.

Government Response

Federal officials condemned Zamora-Quezada’s actions, describing them as a serious betrayal of patient trust. The Justice Department, FBI, and Health and Human Services Office of Inspector General (HHS-OIG) worked together to investigate the case.

Matthew R. Galeotti, head of the Justice Department’s Criminal Division, stated that medical professionals who exploit patients for financial gain will be aggressively pursued and held accountable.

Authorities emphasized the importance of investigating health care fraud, not only to protect patients from harm but also to ensure that public funds and insurance providers are not misused.

Final Outcome

In addition to serving his 10-year prison sentence, Zamora-Quezada lost significant assets gained from fraudulent billing, including multiple properties, vehicles, and a private jet. His case highlights the severity of health care fraud, its impact on patients, and the ongoing efforts of federal agencies to identify and prosecute fraudulent medical practices.