Suburban Chicago Physician Sentenced to Ten Years in Prison for Health Care Fraud

CHICAGO — A suburban Chicago physician has been sentenced to ten years in federal prison for billing Medicaid and private insurers for nonexistent and unnecessary services. MONA GHOSH owned and operated Progressive Women’s Healthcare, S.C., a medical office in Hoffman Estates, Ill., specializing 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 medically necessary, including endometrial ablations and biopsies, ultrasounds, vaccinations, laboratory blood tests, and tests for sexually transmitted diseases. Some of the procedures were performed without patient consent. 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. Ghosh prepared false patient medical records to support the fraudulent reimbursement claims. Ghosh, 52, of Inverness, Ill., pleaded guilty last year to two counts of health care fraud. On Monday, U.S. District Judge Franklin U. Valderrama imposed the ten-year prison sentence and ordered Ghosh to pay approximately $1.5 million in restitution.

Read more on www.justice.gov

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