News Release: Dr. Mona Ghosh Pleads Guilty to Health Care Fraud Charges

July 1, 2024 - After an investigation by the Federal Bureau of Investigation and criminal prosecution by the United States Attorney’s Office of Northern Illinois, Dr. Mona Ghosh has pleaded guilty to two counts of health care fraud. Dr. Ghosh operated a health care clinic, Progressive Women’s Healthcare, S.C., in Hoffman Estates, Illinois between 2013 and 2022, where she provided obstetrics and gynecology services. According to the U.S. Attorney’s Office, she submitted numerous fraudulent claims to Medicare, Medicaid, and other insurers between 2018 and 2022 for services that were not provided or procedures that were not medically necessary.

In the plea agreement, Dr. Ghosh admitted to multiple serious charges. She stated that she submitted fraudulent reimbursement claims to health care benefit programs operated by Medicaid, Blue Cross Blue Shield of Illinois, Medicare, Cigna, Aetna, Humana, and others. These included claims for office visits that supposedly took place during times when Dr. Ghosh was outside of the state of Illinois, as well as claims for telemedicine services that were based on unscheduled phone calls and voicemail messages.

Dr. Ghosh also admitted to providing medical procedures and tests that were not medically necessary in order to receive reimbursement for these services. In many cases, Dr. Ghosh did not receive permission from patients before performing these tests or procedures. According to the plea agreement, she performed endometrial biopsies, ultrasounds, urinalysis, cervical swabs, and blood work. Dr. Ghosh ordered testing for sexually transmitted diseases even in situations where patients were not sexually active or were in monogamous relationships. In some cases, unnecessary tests were performed on healthy patients as frequently as multiple times per week. She also administered hepatitis vaccines to patients multiple times even though these are only needed once.

The U.S. Attorney’s Office has determined that Dr. Ghosh received nearly $2.5 million in fraudulent reimbursements for claims submitted between 2018 and 2022. However, it is likely that additional fraudulent claims were made prior to 2018. As part of the plea agreement, Dr. Ghosh admitted to receiving more than $1.5 million in fraudulent reimbursements. The sentencing hearing for Dr. Ghosh is scheduled for October 22, 2024. Each of the two counts of health care fraud carry a maximum sentence of 10 years and a maximum fine of $250,000 or twice the gross gain received from fraudulent activities. Dr. Ghosh may also be required to pay restitution to patients who were affected.

In addition to the criminal case against Dr. Ghosh, civil lawsuits are moving forward. Patients who have suffered harm due to unnecessary medical procedures, including endometrial ablations or hysterectomies, may take steps to recover financial compensation. Former patients of Dr. Ghosh are encouraged to reach out to Birth Injury Law Alliance, Ltd. to learn about their legal options. In addition to recovering compensation through civil lawsuits, patients may be eligible for restitution ordered during Dr. Ghosh’s sentencing. Contact Attorney Adam Snyder and our team today to learn more about how we can help victims achieve justice. Call 312-462-4200 to arrange a free, confidential consultation.