Mona Ghosh, a 51-year-old Indian American physician based in the Chicago area, has pleaded guilty to federal healthcare fraud charges. Ghosh, who owns and operates Progressive Women’s Healthcare, specializing in obstetrics and gynecology services, admitted to two counts of health care fraud in connection with billing Medicaid and private insurers for services that were either nonexistent or medically unnecessary.
According to federal prosecutors, Ghosh is implicated in a scheme that fraudulently obtained at least $2.4 million in reimbursements. In her plea agreement, Ghosh acknowledged responsibility for over $1.5 million of these fraudulent claims. The exact amount she will be held accountable for will be determined during sentencing, scheduled for October 22 before US District Judge Franklin U Valderrama.
Court documents reveal that between 2018 and 2022, Ghosh and her employees allegedly submitted false claims to Medicaid, TRICARE, and other insurers. These claims included billing for procedures and services that were never provided, not medically necessary, or performed without patient consent. Ghosh also purportedly exaggerated the complexity and duration of in-office and telemedicine visits, and used incorrect billing codes to maximize reimbursement rates.
As part of her fraudulent activities, Ghosh admitted to fabricating patient medical records to substantiate the false claims submitted for reimbursement.
Each count of healthcare fraud Ghosh pleaded guilty to carries a potential sentence of up to ten years in federal prison. The case underscores ongoing efforts by federal authorities to combat healthcare fraud, which impacts both public and private insurers.
Sources By Agencies
