Cook County physician performed 'medically unnecessary' procedures to obtain fraudulent payments: indictment

A Cook County physician was indicted this week by a federal grand jury on 13 counts of healthcare fraud.

Mona Ghosh, 50, of Inverness, was a licensed physician who owned and operated Progressive Women's Healthcare S.C. in Hoffman Estates. 

According to the indictment, Ghosh allegedly participated in a scheme to defraud the government programs of TRICARE and Medicaid, along with several private insurance companies, from February 2018 to April 2022.

Ghosh allegedly knowingly submitted fraudulent claims for reimbursement for services that were not provided and for services that were not medically necessary, including claims for purported telemedicine visits when Ghosh didn't speak to the patient, claims for office visits and procedures when Ghosh didn't see the patient, claims for procedures predicated on false diagnosis and claims for medically unnecessary procedures and tests.

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Ghosh also fraudulently obtained, and caused the business to obtain, about $796,000 in fraudulent payments from multiple healthcare benefit programs for services that were not provided as billed, prosecutors said.

"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 [the] 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."

Each count of health care fraud is punishable by up to 10 years in federal prison.