CHICAGO — A suburban Chicago OBGYN doctor, Mona Ghosh, has admitted to a shocking scam that defrauded Medicaid and private insurers by billing them for services that were never provided. This revelation comes after she was indicted in March 2023.
Dr. Mona Ghosh owned and operated Progressive Women’s Healthcare in Hoffman Estates, Illinois. From 2018 to 2022, she turned her medical practice into a cash machine by performing unnecessary tests and procedures, submitting fake medical records, and using billing codes that would bring in more money. Some of these procedures were done without the patients' consent.
Ghosh exaggerated the complexity and length of both in-person and telemedicine visits to get higher reimbursement rates. She even created false patient records to back up her fraudulent claims.
Ghosh, 51, of Inverness, Illinois, pleaded guilty to two counts of health care fraud. Each count could lead to up to ten years in federal prison. Her sentencing is scheduled for October 22, 2024, by U.S. District Judge Franklin U. Valderrama.
The government claims Ghosh is responsible for at least $2.4 million in fraudulently obtained reimbursements, although Ghosh has admitted to over $1.5 million. The exact amount will be decided at her sentencing.
This guilty plea was announced by several law enforcement officials, including Acting U.S. Attorney Morris Pasqual and FBI Special Agent-in-Charge Robert W. “Wes” Wheeler, Jr., among others. The case is being prosecuted by Assistant U.S. Attorney Misty N. Wright.
Background:
Dr. Mona Ghosh, 50, was indicted by a federal grand jury on thirteen counts of health care fraud. From February 2018 to April 2022, she submitted fraudulent claims for services that were either unnecessary or not provided at all.
This included fake telemedicine visits where she never spoke to the patient and office visits for procedures that never happened. Her scam also involved medically unnecessary tests and procedures, such as endometrial ablations and laboratory testing. She defrauded approximately $796,000 from various health care programs.
- Dr. Ghosh exaggerated the complexity of visits and falsified patient records.
- She performed unnecessary procedures and tests without patient consent.
- She admitted to fraudulently obtaining over $1.5 million.
- Each count of health care fraud carries up to ten years in federal prison.
Dr. Mona Ghosh's guilty plea is a significant step in upholding the integrity of healthcare systems and ensuring that those who commit fraud are held accountable. The sentencing on October 22, 2024, will finalize the extent of her punishment.