Chicago doctor sentenced to 10 years for health care fraud scheme

Chicago doctor sentenced to 10 years for health care fraud scheme

A physician based in suburban Chicago has been sentenced to a decade in federal prison for defrauding Medicaid and private insurance providers by billing for services that were either unnecessary or never performed.

Dr. Mona Ghosh, 52, operated Progressive Women’s Healthcare, S.C., an obstetrics and gynecology clinic located in Hoffman Estates, Illinois. Between 2018 and 2022, she submitted false claims to Medicaid, TRICARE, and other private insurers for procedures such as ultrasounds, lab tests, endometrial biopsies, and even vaccinations—many of which were not medically required. Some procedures were allegedly performed without the informed consent of patients.

Investigators also found that Ghosh exaggerated the time and complexity of both in-person and telemedicine appointments. She used billing codes meant for more extensive care to receive inflated reimbursements, and fabricated patient records to justify the claims.

Ghosh pleaded guilty last year to two counts of healthcare fraud. On Monday, U.S. District Judge Franklin U. Valderrama sentenced her to ten years in prison and ordered restitution of approximately $1.5 million.

Authorities described the case as a severe violation of patient trust. U.S. Attorney Andrew S. Boutros noted that some procedures performed had long-term health implications, including affecting patients’ fertility. FBI Special Agent-in-Charge Douglas DePodesta called her conduct “an extreme betrayal” of patient care.

Officials from the Department of Health and Human Services, Defense Criminal Investigative Service, and the Illinois Attorney General’s Office participated in the investigation. The case was prosecuted by Assistant U.S. Attorneys Kavitha Babu and Hayley Altabef.

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