A suburban Chicago physician has been sentenced to ten years in federal prison for orchestrating a multi-year healthcare fraud scheme that endangered patient health and drained taxpayer resources.
Dr. Mona Ghosh, 52, of Inverness, pled guilty last year to two counts of healthcare fraud. On June 9, U.S. District Judge Franklin Valderrama issued the sentence and ordered Dr. Mona Ghosh to pay $1.5 million in restitution, according to a statement from the United States Attorney’s Office for the Northern District of Illinois.
From 2018 to 2022, Ghosh worked at Progressive Women’s Healthcare, S.C., an obstetrics and gynecology clinic in Hoffman Estates, Illinois. During that time, she and her employees submitted fraudulent claims with Medicaid, Tricare, and private insurance companies.
The fraudulent claims included invoicing for operations that were either unnecessary or never done, such as endometrial ablations, biopsies, ultrasounds, vaccines, blood tests, and STD testing. Prosecutors asserted that they performed several of the treatments without the patient’s consent.
Ghosh also inflated the length and complexity of office and telemedicine sessions by using billing codes intended for larger reimbursements, even when the services given did not qualify. She fabricated bogus medical records to back up her assertions, which exacerbated the deception.
“Dr. Ghosh spent years traumatizing patients, lying to insurers, and stealing taxpayer money to feed her greed,” said FBI Special Agent-in-Charge Robert W. ‘Wes’ DePodesta in the statement released by the U.S. Attorney’s Office.
U.S. Attorney Morris Pasqual went on to say that Ghosh’s conduct was “particularly egregious” since she put patients at risk by performing needless surgeries that hindered some patients’ capacity to have children.
While the financial toll was high, officials emphasized the personal impact on victims. Ghosh’s strategy jeopardized patient safety and breached the trust patients had in her. Some underwent unnecessary medical operations, potentially jeopardizing their long-term health and fertility.
The federal investigation discovered that Ghosh had directed her workers to participate in the plan. The organized nature of the scam raised severe issues about her clinic’s overall operation and how it exploited healthcare systems.
Prosecutors praised the patients’ courage in coming forward, calling them vital to holding Ghosh accountable.
Ghosh’s imprisonment comes after a succession of high-profile healthcare fraud cases involving medical practitioners of Indian ancestry. Tonmoy Sharma, 61, a psychiatrist originating from Guwahati, Assam, was detained earlier this month at Los Angeles International Airport in connection with an alleged $149 million fraud scheme involving his company, Sovereign Health Group.
Despite being unrelated, both incidents underscore growing concerns about fraud in private medical practices and addiction treatment facilities in the United States.
The Ghosh case illustrates the value of control in private healthcare, especially when taxpayer dollars are involved. “When physicians submit fraudulent claims to federal healthcare programs, they divert resources away from those who truly need them,” according to U.S. Attorney Pasqual.
Ghosh’s ten-year sentence adds to the growing list of healthcare workers facing criminal charges for fraud and abuse. Authorities stressed that the case should serve as a caution to anyone who is tempted to exploit the healthcare system for personal benefit.