Suburban Chicago Physician Pleads Guilty to Federal Health Care Fraud Charges

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Suburban Chicago Physician Pleads Guilty to Federal Health Care Fraud Charges (Chicago, IL) — A suburban Chicago physician has pleaded guilty to federal health care fraud charges for billing Medicaid and private insurers for nonexistent services.

Mona Ghosh owned and operated Progressive Women’s Healthcare, S.C., a medical office in Hoffman Estates, Ill., specializing in obstetrics and gynecology services. From 2018 to 2022, Ghosh submitted and caused her employees to submit fraudulent claims to Medicaid, TRICARE, and numerous other insurers for procedures and services that were not provided or were not medically necessary, some of which were performed without patient consent. Ghosh also 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. Ghosh admitted in the plea agreement that she prepared false patient medical records to support the fraudulent reimbursement claims.

Ghosh, 51, of Inverness, Ill., pleaded guilty Thursday to two counts of health care fraud. Each count is punishable by up to ten years in federal prison. U.S. District Judge Franklin U. Valderrama set sentencing for Oct. 22, 2024.

It is the government’s position that Ghosh is accountable for at least $2.4 million in fraudulently obtained reimbursements. Ghosh admitted in the plea agreement that she is accountable for more than $1.5 million of such fraudulently obtained reimbursements. The final amount will be determined by the Court at sentencing.

The plea agreement was announced by Morris Pasqual, Acting United States Attorney for the Northern District of Illinois; Robert W. “Wes” Wheeler, Jr., Special Agent-in-Charge of the Chicago Field Office of the FBI; Darrin K. Jones, Special Agent-in-Charge of the U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Southeast Field Office; Mario Pinto, Special Agent-in-Charge of the Chicago Division of the U.S. Department of Health and Human Services, Office of Inspector General; and Kwame Raoul, Illinois Attorney General.  The government is represented by Assistant U.S. Attorney Misty N. Wright.

READ THE PLEA AGREEMENT HERE

Suburban Chicago Physician Pleads Guilty to Federal Health Care Fraud Charges

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