iNDICA NEWS BUREAU
The U.S. Attorney’s office has announced that Dr. Mona Ghosh, a 51-year-old Indian-American physician from Inverness, Illinois, has pleaded guilty to two counts of federal healthcare fraud. The charges stem from a complex scheme involving her medical practice, Progressive Women’s Healthcare, located in Chicago.
Dr. Ghosh, who specializes in obstetrics and gynecology, admitted to orchestrating a widespread fraud operation that targeted Medicaid, TRICARE, and numerous private insurance companies. The scheme involved submitting false claims for medical services and procedures that were either never performed or were medically unnecessary.
The fraud included several deceptive practices. Dr. Ghosh deliberately overstated the duration and complexity of both in-office and telemedicine visits. She also used inappropriate billing codes to claim higher reimbursement rates for services that did not qualify for such rates. Furthermore, she falsified medical records to support the fraudulent insurance claims, creating a paper trail to back up her illicit activities.
The guilty plea, entered on Thursday, June 27, 2024, covers two counts of healthcare fraud. Each count carries a maximum sentence of 10 years in prison, potentially exposing Dr. Ghosh to a total of 20 years of incarceration. The court has scheduled her sentencing for October 22, 2024.
According to the U.S. Attorney’s office, Dr. Ghosh has been held accountable for fraudulently obtaining at least $2.4 million (approximately ₹203 million) in reimbursements. However, the final amount of restitution will be determined by the court during the sentencing phase.
The case against Dr. Ghosh began in March 2023 when a federal grand jury indicted her on charges of healthcare fraud. The initial indictment alleged that the physician and her clinic had fraudulently obtained $796,000 (about ₹66.4 million) through their scheme. At that time, Dr. Ghosh faced 13 counts of healthcare fraud, with each count carrying a potential 10-year prison sentence.
The reduction from 13 counts to 2 counts suggests that a plea agreement may have been reached between Dr. Ghosh and federal prosecutors, though specific details of any such agreement have not been disclosed.
