Indian-American gynecologist Mona Ghosh admits to massive healthcare fraud scheme

In a shocking revelation, Dr. Mona Ghosh, a 51-year-old Indian-American gynecologist based in Chicago, has pleaded guilty to two federal counts of healthcare fraud. This admission has unveiled a sprawling scheme involving millions of dollars in fraudulent claims to Medicaid and private insurers for treatments that were never provided. This case highlights a troubling trend of healthcare fraud that has significant implications for the industry and patients alike.

Dr. Ghosh, who owned and operated Progressive Women’s Healthcare, orchestrated a fraudulent operation by filing claims for operations and services that were either unnecessary or never performed. According to the United States Attorney’s Office, Ghosh “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 to seek higher reimbursement rates.” The deceit extended to fabricating medical records to support these false claims.

The financial toll of Ghosh’s fraud is staggering. She is reported to have gained at least USD 2.4 million (about Rs 20.03 crore) in ill-gotten reimbursements. Her indictment came in March last year after a federal grand jury took up her case, revealing that she and her clinic had deceitfully obtained approximately USD 796,000 (around Rs 6.64 crore).

As Ghosh faces a potential maximum of 20 years in prison—10 years for each count—the healthcare community is left reeling from the extent of her deceit. Sentencing is set for October 22, where the full scope of her financial penalties will be determined. This case serves as a potent reminder of the vulnerabilities in healthcare billing systems and the need for vigilant oversight.