A physician from suburban Chicago has been sentenced to ten years in federal prison for committing health care fraud. Mona Ghosh, who owned and operated Progressive Women’s Healthcare, S.C. in Hoffman Estates, Illinois, was found guilty of billing Medicaid and private insurers for services that were either nonexistent or unnecessary.
From 2018 to 2022, Ghosh submitted fraudulent claims to Medicaid, TRICARE, and other insurers for procedures that were not medically necessary. These included endometrial ablations and biopsies, ultrasounds, vaccinations, laboratory blood tests, and tests for sexually transmitted diseases. Some procedures were conducted without patient consent. Additionally, Ghosh overstated the length and complexity of visits to receive higher reimbursements and falsified patient medical records to support these claims.
Ghosh pleaded guilty last year to two counts of health care fraud. U.S. District Judge Franklin U. Valderrama sentenced her on Monday and ordered her to pay approximately $1.5 million in restitution.
The sentencing was announced by several officials including Andrew S. Boutros, United States Attorney for the Northern District of Illinois; Douglas S. DePodesta from the FBI's Chicago Field Office; Mario Pinto from the U.S. Department of Health and Human Services; Jason Sargenski from the Department of Defense's Office of Inspector General; and Kwame Raoul, Illinois Attorney General.
U.S. Attorney Boutros stated: “When physicians submit fraudulent claims to federal health care programs, they divert taxpayer-funded resources away from those who truly need them.” He added that Ghosh endangered patients' health by performing unnecessary procedures that affected their ability to have children in the future.
FBI Special Agent-in-Charge DePodesta commented on the betrayal of trust: “Dr. Ghosh spent years traumatizing patients... The depraved conduct uncovered in this case represents an extreme betrayal of trust toward patients.”
HHS-OIG Special Agent-in-Charge Pinto emphasized the severity of Ghosh’s crimes: “Physicians... who place profits ahead of patient care do so at the expense of the very people they swore an oath to protect.”
DCIS Special Agent-in-Charge Sargenski reassured service members about their medical care: “It is imperative that our service members have full confidence that the medical care they receive is both legitimate and delivered by healthcare providers who are unwaveringly committed to their well-being.”
