Indian American physician pleads guilty to health care fraud
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DesiMax Wire
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Mona Ghosh, an Indian American suburban Chicago physician has pleaded guilty to federal healthcare fraud charges for billing Medicaid and private insurers for over $2.4 million for nonexistent services.
Ghosh, 51, owned and operated Progressive Women’s Healthcare, S.C., a medical office in Hoffman Estates, Illinois, specializing in obstetrics and gynecology services, according to a Justice Department press release.
From 2018 to 2022, Ghosh allegedly 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.
Ghosh was also accused of fraudulently overstating 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.
READ: Indian American doctor pays $1,850,000 for healthcare fraud (January 10, 2023)
Ghosh admitted in the plea agreement that she prepared false patient medical records to support the fraudulent reimbursement claims.
Ghosh pleaded guilty last Thursday to two counts of healthcare fraud. Each count is punishable by up to ten years in federal prison. US District Judge Franklin U. Valderrama set sentencing for Oct 22, 2024.
Prosecutors charged that Ghosh is accountable for at least $2.4 million in fraudulently obtained reimbursements. Ghosh admitted in the plea agreement that she is accountable for more than $1.5 million of such fraudulently obtained reimbursements. The final amount will be determined by the Court at sentencing.
The plea agreement was announced by Morris Pasqual, Acting United States Attorney for the Northern District of Illinois and officials of the FBI, Departments of Defense and Health and Human Services, and Kwame Raoul, Illinois Attorney General. The government is represented by Assistant US Attorney Misty N. Wright.
