Illinois physician pleads guilty to fraud

An Illinois physician has pleaded guilty to billing Medicaid and private insurers for nonexistent services.  

Mona Ghosh, MD, 51, pleaded guilty to two counts of healthcare fraud, according to a July 1 Justice Department news release. She owned a medical office in Hoffman Estates, Ill., specializing in obstetrics and gynecology services. From 2018 to 2022, Dr. Ghosh submitted fraudulent claims to Medicaid, Tricare and other insurers for procedures and services that were not provided or were not medically necessary, some of which were performed without patient consent.

She also overstated the length and complexity of in-office and telemedicine visits and submitted claims using billing codes for which the visits did not qualify, according to the release. 

In her plea agreement, Dr. Ghosh admitted she was accountable for $1.5 million in fraudulent reimbursements, but the Justice Department alleges she is accountable for $2.4 million, according to the release. 

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