A federal court has sentenced Dr. Jorge Zamora Quezada, a Texas-based rheumatologist, to 10 years in prison for running a long-term health care fraud scheme that caused physical harm to patients and led to more than $118 million in fraudulent medical claims. The sentencing took place on May 21, 2025, marking the end of a case authorities described as one of the most severe examples of patient harm linked to medical fraud in the United States.
Along with the prison term, the court ordered Zamora Quezada to serve three years of supervised release and forfeit assets worth over $28 million, including luxury properties, vehicles, and a private aircraft. Federal investigators said the sentence reflects the scale of deception and the lasting impact on patients who trusted him with their care.
Court records show that Zamora Quezada, 68, operated his scheme for nearly 20 years while practicing in Mission, Texas. During that time, he falsely diagnosed hundreds of patients with serious autoimmune and rheumatologic diseases they did not have.
Prosecutors said he deliberately targeted elderly patients, individuals with chronic pain, and people with limited English proficiency, knowing they were less likely to question medical decisions. Many patients were told they had lifelong, progressive conditions that required constant monitoring and aggressive treatment.
These false diagnoses allowed the doctor to justify repeated office visits, extensive testing, and high-cost medical procedures.
Patients testified that they were subjected to intravenous infusions, powerful medications, and even chemotherapy-type drugs without medical need. Several victims reported severe side effects, including chronic pain, physical weakness, and emotional distress after undergoing treatments they later learned were unnecessary.
According to federal prosecutors, Zamora Quezada continued prescribing these treatments even when test results showed no evidence of disease. In many cases, patients trusted the diagnosis completely and followed treatment plans for years.
Fox News, while reporting on the case, highlighted that the scheme went beyond financial fraud and caused direct and repeated patient harm, making it one of the most significant cases of its kind.
Investigators found that Zamora Quezada submitted more than $118 million in false claims to Medicare, Medicaid, TRICARE, and private insurance companies, including Blue Cross Blue Shield. Of that amount, insurers paid out over $28 million for treatments and tests that were medically unjustified.
The fraudulent billing covered lab work, imaging, procedures, and infusion therapies that were either unnecessary or never provided. Federal authorities said the scheme drained public health care resources and increased costs for taxpayers.
The case against Zamora Quezada strengthened after investigators uncovered evidence of obstruction of justice. Prosecutors said he altered and falsified patient medical records after learning that a federal grand jury was investigating his practice.
These changes were meant to support false diagnoses and justify billing claims. A jury ultimately found him guilty after a 25-day federal trial, convicting him on:
One count of conspiracy to commit health care fraud
Seven counts of health care fraud
One count of conspiracy to obstruct justice
As part of the sentencing, the court ordered the forfeiture of assets purchased with fraud proceeds. These included 13 real estate properties, a private jet, and a Maserati GranTurismo. Authorities said the seized assets would be used to recover losses and return funds to affected programs.
Federal officials described the forfeiture as a key step in restoring trust in the health care system and holding providers accountable for financial misconduct.
The Department of Health and Human Services Office of Inspector General stated that protecting patients remains a top enforcement priority, particularly when fraud schemes involve physical harm.
Reference:
U.S. Department of Health and Human Services, Office of Inspector General. Texas Doctor Who Falsely Diagnosed Patients Sentenced to 10 Years’ Imprisonment in Connection with $118M in Fraudulent Health Care Claims. May 21, 2025. Accessed [date you accessed]. HHS Office of Inspector General website.
https://oig.hhs.gov/fraud/enforcement/texas-doctor-who-falsely-diagnosed-patients-sentenced-to-10-years-imprisonment-in-connection-with-118m-in-fraudulent-health-care-claims/