Women's health care doctor accused of defrauding insurance companies, Medicaid
CHICAGO (CBS) -- A northwest suburban doctor has been indicted by a federal grand jury on charges that she submitted fraudulent reimbursement requests for services she either didn't provide or that weren't medically necessary.
Dr. Mona Ghosh, 50, of Inverness, was the owner and operator of Progressive Women's Healthcare S.C. in Hoffman Estates, according to the U.S. Attorney's office.
Prosecutors alleged Ghosh defrauded the federal government programs of TRICARE and Medicaid – as well as several private insurance companies – including Blue Cross Blue Shield of Illinois.
The indictment claimed Ghosh billed the government programs and insurance companies for purported telemedicine visits in which she did not really speak to the patient and in-office visits and procedures in which she did not really see the patient.
Ghosh was also accused of filing claims for procedures that were predicated on false diagnoses, and that were not medically necessary – including lab tests and endometrial ablations, a procedure in which the lining of the uterus is removed to reduce heavy menstrual bleeding.
Ghosh and her clinic fraudulently obtained about $796,000, the indictment said.
"Targeting government and private healthcare programs relied on by the public to maintain their well-being is a serious crime," Acting U.S. Attorney Morris Pasqual said in a news release. "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."
Ghosh is charged with 13 counts of health care fraud. Each count carries a maximum sentence of 10 years in federal prison.
The FBI is seeking information in the investigation into Dr. Ghosh. Anyone who believes they or their minor dependents were victimized by Ghosh, or has relevant information, is asked to fill out a form available at this link.
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