New York, United States

A 51-year-old Chicago-based Indian-American doctor pleaded guilty to two federal counts of healthcare fraud, for billing Medicaid and private insurers for treatments that were never provided. 

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Progressive Women's Healthcare, a gynaecology and obstetrics speciality, was owned and controlled by Mona Ghosh.

Ghosh and her staff had filed payment claims to Medicaid, TRICARE, and many other insurance companies for operations and services that were either not medically required or not rendered at all.

According to the United States Attorney's Office, Ghosh "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 to seek higher reimbursement rates."

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Attorney's Office further stated that she admitted to fabricating medical records to back up the fake claims for payment to the insurance companies.

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Ghosh, the Indian-American physician from Inverness, Illinois, pleaded guilty to two counts of healthcare fraud on June 27. Each count carries a maximum penalty of 10 years in prison. Sentencing is scheduled for October 22.

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According to the US Attorney's office, Ghosh is responsible for getting at least USD 2.4 million (about Rs 20.03 crore) in reimbursements through fraud. A US court will determine the total sum during the sentence.

Ghosh was charged with healthcare fraud in March of last year after a federal grand jury indicted her. CBS News stated that the indictment reported that the doctor and her clinic used deceptive methods to acquire USD 796,000, or approximately Rs 6.64 crore.

Thirteen charges of healthcare fraud were brought against Ghosh, and each carries a ten-year prison sentence.

(With inputs from agencies)