U.S. Attorney for the Northern District of Illinois: Physician Indicted on Thirteen Counts of Healthcare Fraud

CHICAGO, Illinois, March 15 -- The office of the U.S. Attorney for the Northern District of Illinois issued the following news release:

A suburban Chicago physician has been indicted by a federal grand jury in Chicago on thirteen counts of health care fraud for submitting fraudulent requests for reimbursement.

As alleged in the indictment, from February 2018 to April 2022, MONA GHOSH, 50, of Inverness, a licensed physician who owned and operated Progressive Women's Healthcare, S.C. (Progressive) in Hoffman Estates, participated in a scheme to defraud the government programs of TRICARE and Medicaid, along with several private insurance companies. The indictment alleges that Ghosh knowingly submitted fraudulent claims for reimbursement for services that were not provided and for services that were not medically necessary. These included claims for purported telemedicine visits when Ghosh did not speak to the patient, claims for office visits and procedures when Ghosh did not see the patient, claims for procedures predicated on false diagnosis, and claims for medically unnecessary procedures and tests, including endometrial ablations and laboratory testing. Ghosh fraudulently obtained, and caused Progressive to obtain, approximately $796,000 in fraudulent payments from multiple health care benefit programs for services that were not provided as billed.

The indictment is announced by Morris Pasqual, Acting United States Attorney for the Northern District of Illinois; Robert W. Wheeler, Jr., Special Agent-in-Charge of the Chicago Office of the Federal Bureau of Investigation; and Darrin K. Jones, Special Agent in Charge of the Department of Defense, Office of Inspector General, Defense Criminal Investigative Service (DCIS), Southeast Field Office; Mario Pinto, Special Agent in Charge of the Department of Health and Human Services, Office of the Inspector General; and the Illinois Medicaid Fraud Control Unit. The government is represented by Assistant U.S. Attorney Misty Wright and Kavitha Babu.

"Targeting government and private healthcare programs relied on by the public to maintain their well-being is a serious crime," said Acting U.S. Attorney Pasqual. "In addition to submitting false claims, the allegation that defendant performed medically unnecessary procedures to enrich herself is particularly disturbing. This office will continue to work closely with our law enforcement partners to prosecute those who steal from healthcare programs and who needlessly put patients at risk."

"When healthcare providers illegally manipulate our healthcare system, it diminishes the trust Americans have in vital programs. The FBI is proud to stand with our law enforcement partners and ensure justice is served" said Special Agent in Charge Wheeler.

"Health care providers who submit fraudulent claims for unnecessary and non-rendered services not only waste valuable taxpayer dollars, but also undermine the trust and confidence of their patients," said Special Agent in Charge Pinto. "We will continue to work together with our law enforcement partners to ensure that individuals who commit fraud against our federal health care programs are held accountable."

"Those who place profit before patient care, impacting the welfare of our service members and their families, must be held accountable," said Special Agent in Charge Jones. "DCIS proudly stands together with our law enforcement partners and the Department of Justice to root out fraud, waste, and abuse in the healthcare industry."

The public is reminded that an indictment contains only a charge and is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt. Each count of health care fraud is punishable by up to 10 years in federal prison. If convicted, the Court must impose a reasonable sentence under federal statutes and the advisory U.S. Sentencing Guidelines.

If you or someone you know is a victim of Dr. Mona Ghosh or if you have any information, please contact the FBI at [email protected].

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Original text here: https://www.justice.gov/usao-ndil/pr/physician-indicted-thirteen-counts-healthcare-fraud