A physician in the Chicago suburbs has pleaded guilty to a $2.4 million healthcare fraud scheme of billing Medicaid and private insurers for nonexistent services.
From 2018 to 2022, Mona Ghosh, MD, owner and operator of the Hoffman Estates, Ill.-based medical office Progressive Women's Healthcare, submitted and caused her employees to submit fraudulent claims to Medicaid, TriCare and other insurers, the Justice Department said in a July 1 news release.
Dr. Ghosh billed for procedures that were either not provided, medically unnecessary or performed without patient consent, according to the report. She also overstated the length and complexity of the procedures for higher reimbursement rates, as well as prepared false patient medical records to support the fraudulent claims.
She pleaded guilty to two counts of healthcare fraud, and her sentencing is set for Oct. 22. In her plea agreement, Dr. Ghosh admitted she was accountable for $1.5 million in fraudulent reimbursements, but the federal government alleges she is accountable for $2.4 million.