$325 Million in Healthcare Fraud
PCG originally published a story about this case in January 2020, but we've updated it because no one is providing a conclusion to this horrendous crime.
Summary:
On January 15, 2020, a Texas Rheumatologist, Dr. Jorge Zamora-Quezada was tried and found guilty of 7 counts of healthcare fraud, 1 count of conspiracy to obstruct justice, and 1 count of conspiracy to commit healthcare fraud. The total damage from his fraudulent activities totals over $325 million. We go over the fraudulent behavior but also shine a light on the failure of local and national media to follow up on the conclusion of this story.
False Diagnosis for Fraudulent Billing and Harmful Treatments
Dr. Zamaro-Quezda falsely diagnosed patients of all ages with chronic diseases in order to submit payments for labs, treatments, and expensive surgeries that patients did not need medically and that endangered their lives. Unnecessary and fraudulent billing and services spanned years for some patients. Officer of Inspector General CJ Porter stated the OIG rarely sees such “unthinkably callous and cruel criminal conduct, committed for the sheer sake of greed.”
His profits fueled his Maserati, private jet, and luxurious lifestyle, while he ruined his patients' lives.
Patients are Often Forgotten in Fraud...
Too many times we focus only on the financial loss of fraud, but in this case, we are reminded that patients as young as 13 were fraudulently diagnoses with different diagnoses of arthritis (rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, and others) and then given unnecessary self-injections, sometimes infusions, and even chemotherapy drugs to which the Doctor then billed Medicare and Medicaid for. Patients suffered physical, emotional, and psychological damage that will last for years to come.
Media Reports but Doesn't Follow-Up
This fraud case was first investigated in 2020 and the last article updating the world we can find on the internet was in mid-2022. When you search "Dr. Jorge Zamora sentence", all you get are articles about its delays. To this date, there is literally no information online or on the FBI or governmental agency websites on how long this man will spend in prison. This is an example of publishing and embellishing the crime but not providing the world with a deterrent. If we are to spearhead the deterrence of Healthcare Fraud we must enforce the sanctions and publicize the consequences for fraud.
