What type of case leads the government to call a rheumatologist one of the worst criminals when it comes to health care fraud? According to the U.S. Attorney for the Southern District of Texas, one that prescribes chemotherapy treatment for rheumatoid arthritis. The Attorney stated that the fact the trial took so long shows that Dr. Zamora-Quezada was one of the “worst medical fraudsters” that court had seen.
What was this case?
The government accused the physician of falsely diagnosis patients with rheumatoid arthritis and then treating them with medically unnecessary and toxic medications including chemotherapy drugs. The prosecution further claimed that once the doctor realized he was facing allegations of healthcare fraud he falsified patient records in an attempt to thwart the investigation.
The government presented evidence to support these allegations and show that the physician and his staff gained over $325 million from the government as part of this alleged scheme and used these funds to support a lavish lifestyle which included a Maserati and vacations on a private jet.
After 25 days at trial, a federal jury convicted the rheumatologist of one count of conspiracy to commit health care fraud, seven counts of health care fraud, and one count of conspiracy to obstruct justice. This was back in January of 2020. The court was supposed to move forward with sentencing months later but, due to the pandemic, is just now planning to move forward with sentencing. Yet, according to a recent report, the sentencing could get pushed back even further as the investigation into the full impact of the scheme continues.
What does this case mean for physicians who face allegations of healthcare fraud?
The case provides an example of the complexity of healthcare fraud allegations. These cases can take years to resolve. Those who find themselves facing these allegations are wise to seek legal counsel to help build a defense and protect their rights and interests during the process.