Chicago Healthcare Fraud: Indian-Origin Doctor Pleads Guilty

July 2 :
Healthcare fraud charges brought by Medicaid and private insurers for treatments that were never rendered have been plead guilty by a 51-year-old Chicago physician of Indian descent. From 2018 to 2022, the doctor, whose name is Mona Ghosh, was involved in fraudulent operations while running her obstetrics and gynecological practice, Progressive Women's Healthcare, S.C. During this time, Ghosh and her staff submitted fraudulent claims to many insurers, including Medicaid and TRICARE, for treatments and operations that were either not rendered, not required by law, or carried out without the patient's informed consent.

In her plea deal, Ghosh admitted that she used billing codes that did not meet the requirements for seeking higher reimbursement rates, and that she inflated the duration and complexity of both in-office and telemedicine appointments. She came clean about her role in creating fabricated patient medical records to back up these questionable reimbursement requests.

Ghosh, who resides in Illinois's Inverness, pled guilty to two charges of healthcare fraud on June 27. A maximum of ten years in federal prison is possible for each count.

Ghosh is accused by the government of receiving at least $2.4 million in reimbursements that were obtained improperly. Over $1.5 million of these phony payments were admitted by Ghosh in the plea deal. The sum will be decided by the court during sentencing. Since Ghosh is guilty of the allegations contained in Counts Four and Eleven of the indictment, her plea bargain stated that she will plead guilty.