Medical Fraud: One of the Worst Cases in U.S. History

gavel and medical equipment

In January of 2020, The U.S. Department of Justice tried a medical fraud case that shocked everyone involved (other than the accused, presumably). The case revolved around a Texas doctor who was found guilty of the pivotal role he played in a health care fraud scheme of such magnitude that it is difficult to comprehend. In the end, the scheme amounted to $325 million worth of fraud in the form of false diagnoses of life-long diseases.

The Texas rheumatologist – Jorge Zamora-Quezada, M.D, of Mission, Texas – was convicted of charges that include conspiracy to commit health care fraud, health care fraud, and conspiracy to obstruct justice. In fact, the case is one of the worst medical fraud schemes in our nation's history. If you are facing a fraud charge – or any other criminal charge of any magnitude – you need an experienced Coryell County criminal defense attorney in your corner.

A Terrifying Ruse

The doctor’s role included diagnosing patients with life-long diseases that they did not have and then treating them for those false diagnoses with toxic medications. The Justice Department’s Assistant Attorney General shared that the doctor’s conduct was heinous and that he spared no one. The doctor’s efforts included falsely diagnosing the very young, the elderly, and the disabled alike. These patients had to endure invasive treatments that they did not need – in order to aid the doctor’s ongoing efforts to bolster his own wealth.

Massive Fraud

The lengthy trial speaks to the magnitude of the fraud involved in this jaw-dropping case. The Special Agent in Charge relayed that "the guilty verdict against Dr. Zamora-Quezada ensures he will pay a steep price for his unthinkably callous and cruel criminal conduct, committed for the sheer sake of greed.” This is a case of fraud that takes the matter to the next level.

Rheumatoid Arthritis

The doctor’s wrongdoing involved falsely diagnosing patients with rheumatoid arthritis, which is an incurable disease that spans a lifetime. Patients are able to manage the immense pain associated with this disease through heavy-duty pain medications and difficult treatments. As a result of the doctor's fraudulent practices, many patients received treatments that they did not need and that were not medically indicated for them, including the following very serious medical procedures:

  • Chemotherapy

  • Intravenous infusions

To make the matter that much more repugnant, some of the doctor’s victims were as young as 13.

Fraud Charges in the State of Texas

While this federal case is very dramatic (and disturbing), most fraud charges in the State of Texas are far more run of the mill. This does not, however, alter the fact that fraud charges are very serious charges with very serious potential consequences. Fraud is a charge that pertains to the perpetrator’s intent to obtain money or other assets via false means. Fraud charges can span from acts as minor as using someone else’s credit card to order a pizza to schemes as massive as this whopper of federal medical fraud. Whether the fraud charge is a misdemeanor or a felony generally depends upon the type of fraud committed and the amount of money involved.

Common Fraud Charges

Fraud charges can be wide-ranging, but some of the most common categories of fraud charges include:

  • Forgery

  • Counterfeiting

  • Credit card fraud

  • Check fraud

  • Identity theft

  • Unemployment fraud

  • Workers’ compensation fraud

  • Tax fraud

  • Mortgage fraud

  • Insurance fraud

  • Securities fraud

  • Computer fraud

  • Medicaid fraud

  • Welfare fraud

  • Medical fraud

Fraud comes in any number of forms.

Fines and Penalties

The fines, penalties, and social consequences related to a conviction on a fraud charge are considerable and should not be underestimated.

Class C Misdemeanor

If the charge in question involves less than $100, it is a class C misdemeanor that can lead to fines of up to $500.

Class B Misdemeanor

If the charge in question involves between $100 and $750, it is a class B misdemeanor that can lead to up to 180 days in jail and fines of up to $2,000.

Class A Misdemeanor

If the charge in question involves between $750 and $2,500, it is a class A misdemeanor that can lead to up to 180 days in jail and fines of up to $4,000.

State Jail Felony

If the charge in question involves between $2,500 and $30,000, it is a state jail felony that can lead to from 180 days to 2 years in jail and to fines of up to $10,000.

Third-Degree Felony

If the charge in question involves between $30,000 and $150,000, it is a third-degree felony that can lead to from 2 to 10 years in prison and to fines of up to $10,000.

Second-Degree Felony

If the charge in question involves between $150,000 and $300,000, it is a second-degree felony that can lead to from 2 to 20 years in prison and to fines of up to $10,000.

First-Degree Felony

If the charge in question involves more than $300,000, it is a first-degree felony that can lead to from 5 to 99 years in prison and to fines of up to $10,000.

The penalties involved can also be enhanced if the alleged fraud involves the exploitation of someone who is vulnerable, such as an elderly person, a child, or a person with disabilities.

An Experienced Coryell County Criminal Defense Attorney Is Standing by to Help You

Brett Pritchard at The Law Office of Brett H. Pritchard – proudly serving Coryell County, Texas – is a formidable criminal defense attorney who is well aware of the magnitude of your case as it relates to your future and who is committed to championing your rights – in pursuit of a beneficial case resolution. Our savvy legal team puts your needs and best interests first, so please do not wait to contact or call us at 254-501-4040 today for more information about how we can help you.

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