Indian-American physician pleads guilty to $2.4 million healthcare fraud scheme – The Times of India

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NEW DELHI: An Indian American Physician has pleaded guilty to US’ federal healthcare fraud charges for billing Medicaid and private insurers for nonexistent services.
Mona Ghosh, owner and operator of Progressive Women’s Healthcare, which specialises in obstetrics and gynecology services, has pleaded guilty to two counts of healthcare fraud.
In federal prison, each count is punishable by up to ten years.
The sentencing has been set for October 22 by US District Judge Franklin U Valderrama.
Federal prosecutors allege that Ghosh is accountable for at least $2.4 million in reimbursements fraud.
She admitted in her plea agreement that she was responsible for more than $1.5 million of such fraudulently obtained reimbursements.
The final amount will be determined by the court at sentencing, a media release said.
“Northern District of Illinois documents, 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,” the US States Attorney’s office said in a statement.
“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 to seek higher reimbursement rates, her plea agreement states. She admitted that she had prepared false patient medical records to support the fraudulent reimbursement claims,” it added.

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