Indian-American physician Mona Ghosh

Indian-origin physician Mona Ghosh. Photo Courtesy; Mona Ghosh Linkedin page

Indian-origin physician Mona Ghosh has pleaded guilty to federal healthcare fraud charges for billing Medicaid and private insurers for nonexistent services, said the US Attorney’s office on Tuesday. Ghosh owned and operated Progressive Women’s Healthcare, S.C., a medical office in Hoffman Estates, Ill., specialising in obstetrics and gynecology services.

From 2018 to 2022, Ghosh submitted and caused her employees to submit fraudulent claims to Medicaid, TRICARE, and numerous other insurers for procedures and services that were not provided or were not medically necessary, some of which were performed without patient consent, read a statement issued by the US Attorney’s office.

“Ghosh also fraudulently overstated the length and complexity of in-office and telemedicine visits and submitted claims using billing codes for which the visits did not qualify in order to seek higher reimbursement rates, her plea agreement states,” the statement said.

Ghosh admitted in the plea agreement that she prepared false patient medical records to support the fraudulent reimbursement claims.

“Ghosh, 51, of Inverness, Ill., pleaded guilty Thursday to two counts of health care fraud. Each count is punishable by up to ten years in federal prison. U.S. District Judge Franklin U. Valderrama set sentencing for Oct. 22, 2024,” the statement said.

It is the government’s position that Ghosh is accountable for at least USD 2.4 million in fraudulently obtained reimbursements. Ghosh admitted in the plea agreement that she is accountable for more than USD 1.5 million of such fraudulently obtained reimbursements. The final amount will be determined by the Court at sentencing.