Dr. Mona Ghosh, a 52-year-old Indian-American doctor specialising in obstetrics and gynecology, has been sentenced to 10 years in federal prison for defrauding insurance companies out of nearly $2.4 million through fraudulent medical billing practices. Operating out of her medical office, Progressive Women’s Healthcare in Hoffman Estates, Illinois, Dr. Ghosh submitted false claims to Medicaid, TRICARE, and private insurers between 2018 and 2022, billing for procedures that were either unnecessary or never performed.
Who is Mona Ghosh?
Dr. Ghosh was found guilty of submitting claims for a range of medical services, including endometrial ablations, biopsies, ultrasounds, vaccinations, blood tests, and STD screenings, many of which were either not performed or performed without patient consent. Additionally, she exaggerated the length and complexity of office and telemedicine visits, using incorrect billing codes to seek higher reimbursements.
Federal investigators also found that Dr. Ghosh fabricated patient records to support her fraudulent claims, further complicating her extensive scheme. The fraudulent actions not only resulted in stolen taxpayer money but also endangered the health of Ghosh’s patients. According to prosecutors, some of the unnecessary procedures performed by Ghosh limited patients’ ability to have children in the future. “Dr. Ghosh’s fraud scheme was particularly egregious because she endangered the health of her patients by performing unnecessary procedures,” said U.S. Attorney Andrew S. Boutros. “She not only stole taxpayer funds but also caused harm to those who trusted her with their health.”
Investigators’ remarks on the case
The scheme was uncovered through a joint investigation by the FBI, the U.S. Department of Health and Human Services, and the Department of Defense, among others. FBI Special Agent-in-Charge Douglas S. DePodesta said, “The depraved conduct uncovered in this case represents an extreme betrayal of trust toward patients who were simply seeking care and integrity from their doctor.” Authorities emphasised the seriousness of medical fraud, especially when it comes to healthcare professionals exploiting vulnerable patients and defrauding taxpayer-funded health programs. In addition to her 10-year prison sentence, Dr. Ghosh has been ordered to pay approximately $1.5 million in restitution to cover the stolen funds.