A Texas rheumatologist was sentenced to 10 years in prison and three years of supervised release for orchestrating a health care fraud scheme involving over $118 million in false claims, resulting in more than $28 million in payments from insurers, the U.S. Department of Justice announced.
Jorge Zamora-Quezada, M.D., 68, of Mission, was convicted after a 25-day trial 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, he was ordered to forfeit $28,245,454, including 13 real estate properties, a jet, and a Maserati GranTurismo.
Evidence presented at trial showed Zamora-Quezada falsely diagnosed patients with rheumatoid arthritis to defraud Medicare, Medicaid, TRICARE, and Blue Cross Blue Shield. He administered unnecessary treatments and tests, including injections, infusions, X-rays, MRIs, and other procedures with potentially harmful side effects, while falsifying medical records to justify the claims. After receiving a federal grand jury subpoena, he fabricated patient records to obstruct justice.
“Dr. Zamora-Quezada 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 Department’s Criminal Division.
“His depraved conduct represents a profound betrayal of trust toward vulnerable patients who depend on care and integrity from their doctors. Today’s sentence is not just a punishment—it’s a warning. Medical professionals who harm Americans for personal enrichment will be aggressively pursued and held accountable to protect our citizens and the public fisc.”
Testimony revealed that Zamora-Quezada’s false diagnoses led patients to believe they had an incurable, lifelong condition requiring ongoing treatment. Other rheumatologists in the Rio Grande Valley testified that they saw hundreds of Zamora-Quezada’s patients who did not have rheumatoid arthritis, with one physician noting that, for most, it was “obvious that the patient did not have rheumatoid arthritis.”
The unnecessary treatments caused severe side effects, including strokes, jawbone necrosis, hair loss, liver damage, and debilitating pain.
One patient testified, “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.”
A mother described her child as being treated like a “lab rat,” while others spoke of abandoning college plans or feeling like they were “living a life in the body of an elderly person.”
“Through the false diagnoses and excessive false billing, Dr. Zamora-Quezada abused both patient trust and public resources,” said Special Agent in Charge Jason E. Meadows of the U.S. Department of Health and Human Services Office of Inspector General. “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 funds.”
Former employees testified that Zamora-Quezada imposed strict procedure quotas, fostering a climate of fear. He referred to himself as the “eminencia” — or eminence — threw a paperweight at an employee for failing to meet quotas, and manipulated staff on J-1 visas by threatening their immigration status. He also fired employees who challenged him.
To obstruct insurer audits, he fabricated patient files, including using ultrasounds of employees as patient documentation, and instructed staff to “aparecer” missing records — “to make them appear.” Employees were sent to a dilapidated barn to retrieve records infested with rodents, termites, and contaminated with feces and urine.
“The FBI is dedicated to working with all of our partners to address health care fraud,” said Special Agent in Charge Aaron Tapp of the FBI’s 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 case.”
Zamora-Quezada used the proceeds from his scheme to fund a lavish lifestyle, including luxury real estate in the U.S. and Mexico, a jet, and a Maserati.