Former employee, patient take stand in healthcare fraud case

A former employee and patient of Dr. Jorge Zamora Quezada came to his defense Wednesday as part of the ongoing trial for the doctor and his co-defendants who are facing healthcare fraud charges.

Zamora Quezada, a rheumatologist, is on trial over allegations that he participated in a scheme to defraud health insurers by misdiagnosing and over-treating patients.

Co-defendants in the case are his wife, Meisy Zamora, and two of their employees, Estella Santos Natera and Felix Ramos. They are accused of also participating in the scheme which allegedly included tampering with medical records and money laundering to conceal the source of the funds they made from the alleged scheme.

A medical assistant, Janice Gomez, who worked for four and half years at the Center for Arthritis and Osteoporosis, Zamora Quezada’s clinic, testified Wednesday morning about her experience working there.

When she first began working there in 2013, her role was vitalizing patients when they would come in which entailed going over their chief complaint, taking their temperature and weight.

Her role later changed so that she would then go on rounds with Zamora Quezada, which meant she would be present in the examination room with the doctor and the patients.

When Zamora Quezada met with patients, Gomez said he would talk to patients about different ways to mitigate their pain, which included holistic approaches such as light exercise, changes in diet and teas.

When the patients were prescribed methotrexate, Gomez said the doctor would usually start them on the smallest dose.

Attorneys for the defense also went over several patient forms, many of which Gomez had filled out herself.

Among those forms was the fee ticket, or super bill, that documented everything that was ordered for the patient throughout their visit.

Former employees had previously testified about the super bills, stating that they were expected to order the same set of procedures for each patient’s first visit, another set of procedures for each patient’s second visit, and another set of procedures for each patient’s third visit.

Gomez testified, though, that she would fill that out based off of what Zamora Quezada said during the visit.

She said she did not intentionally insert any false information into the patient’s forms and she was never instructed to do so.

She also said she never heard Zamora Quezada talk about quotas for the number of patients to be seen per day, and to her understanding, there were no such quotas, contrary to the testimony of other former employees.

Gomez added that she had made complaints against her supervisor, Jose Tomas Moreno, alleging he had made sexual remarks about her and that he was regularly late to work or was simply not present.

Moreno testified earlier during the trial as a witness for the government, stating that Zamora Quezada asked him and another medical assistant to replace missing ultrasound images with those that belonged to different patients.

This was allegedly done after the clinic was asked to turn over documents for an audit but some patients’ ultrasound images couldn’t be found.

When she was questioned by the government, Gomez clarified that because she is not a rheumatologist, she had to trust that Zamora Quezada’s diagnoses were correct and the treatments were appropriate.

She also has no knowledge of the clinic’s billing practices and what was being billed to insurers.

Following Gomez’s testimony, a former patient briefly took the stand, praising Zamora Quezada’s medical treatment.

Martha Luisa Garza, of Mission, had seen two rheumatologists before going to Zamora Quezada in 2017.

As the defense displayed her medical records from her visits with Zamora Quezada, she said the records were accurate, a distinction from other patients who testified for the government and said some of their records were inaccurate.

She was initially diagnosed with rheumatoid arthritis by one of the previous rheumatologists she had seen and Zamora Quezada affirmed that diagnosis.

When she visited with him, Garza said he recommended holistic approaches to treatment such as vitamins and a change in diet. However, she was also prescribed methotrexate and said she felt better after taking the drug.

After his arrest in 2018, Garza said she went to another doctor who had discontinued the medication, after which she said she began to feel worse. She was then put on the drug again.

Garza’s testimony concluded Wednesday’s proceedings. The trial is scheduled to continue Thursday morning when the defense will call more witnesses to testify.