Hoffman Estates Doc Pleads Guilty To Federal Health Care Fraud Charges

HOFFMAN ESTATES, IL — A Hoffman Estates physician pled guilty last Thursday to federal health care fraud charges for reportedly billing Medicaid and private insurers for nonexistent services. Mona Ghosh, 51, of Inverness, owned and operated Progressive Womens Healthcare, S.C., a medical office specializing in obstetrics and gynecology services.

Ghosh pled guilty to counts of health care fraud, each punishable by up to 10 years in federal prison. Sentencing is scheduled for Oct. 22.

According to federal prosecutors, from 2018 to 2022, Ghosh submitted and caused her employees to submit fraudulent claims to Medicaid, Tricare and other insurers for procedures and services not provided or even medically necessary. Some of these were performed without consent from patients.

In addition, Ghosh 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, her plea agreement states. In a plea deal, Ghosh admitted she prepared false patient medical records to support the fraudulent reimbursement claims.

It was ruled Ghosh is accountable for at least $2.4 million in fraudulently obtained reimbursements. She had admitted in the plea agreement that to be accountable for more than $1.5 million of such fraudulently obtained reimbursements. The final amount will be determined by the Court at sentencing.