Indian-American physician gets 10-year jail term for healthcare fraud
A 52-year-old Indian-American physician from Chicago, Mona Ghosh, was sentenced to a 10-year jail term for medical fraud. She submitted reimbursement claims for services and procedures that were either not provided or not medically necessary. Prosecutors said the fraud endangered patients' health and fertility.Between 2018 and 2022, she submitted fraudulent claims to federal programmes such as Medicaid and Tricare, as well as to private insurers, and also directed her employees to do the same.advertisementProsecutors also said some procedures were performed without patient consent, according to a statement issued by the US Attorney's Office, Northern District of Illinois.
Mona Ghosh owned and operated Progressive Women's Healthcare, which specialises in obstetrics and gynaecology services.Her fraudulent claims included endometrial ablations and biopsies, ultrasounds, vaccinations, laboratory blood tests, and tests for sexually transmitted diseases.She used wrong billing codes, a standardised system used to identify and report the services and procedures provided by healthcare professionals in the US, to make the visits seem more serious than they really were, so she could get more money than she was supposed to."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 in order to seek higher reimbursement rates. Ghosh prepared false patient medical records to support the fraudulent reimbursement claims", the statement read.advertisementGhosh, who belongs to Inverness in Illinois, on June 27 last year pleaded guilty to two counts of healthcare fraud. On June 9, US District Judge Franklin U Valderrama imposed the ten-year prison sentence and ordered Ghosh to pay approximately $1.5 million (approximately Rs 12.5 crore) in restitution.MONA GHOSH'S FRAUD ENDANGERED PATIENTS' HEALTH: US ATTORNEY"When physicians submit fraudulent claims to federal health care programs, they divert taxpayer-funded resources away from those who truly need them," said US Attorney Boutros."Dr Ghosh's fraud scheme was particularly egregious because she endangered the health of her patients by performing unnecessary medical procedures, including procedures that severely limited some patients' ability to have children in the future (sic)," Boutros added.The attorney also applauded the victims' strength to come forward and confront this defendant."Dr Ghosh spent years traumatising patients, lying to insurers, and stealing taxpayer money to feed her greed (sic)," said FBI SAC DePodesta.Earlier this month, a US-based, Indian-origin pharma tycoon was arrested at Los Angeles International Airport over his alleged involvement in a $149-million healthcare fraud. Tonmoy Sharma, 61, originally from Guwahati, Assam, is the founder and former CEO of Sovereign Health Group, a company that provides addiction treatment services.
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