An Indian-American doctor, Mona Ghosh, has pleaded guilty to two counts of federal healthcare fraud charges for billing numerous private insurance providers for services that did not exist. The 51-year-old obstetrician and gynaecologist faces 20 years imprisonment, according to the US Attorney's office. Ghosh admitted to falsifying medical records and claiming reimbursements from Medicaid, TRICARE and other private insurers. According to reports, the physician and her clinic obtained US $796,000 (around ₹6.64 crore) through fraud.
Dr Mona Ghosh Pleads Guilty
Dr Mona Ghosh owned and operated an obstetrics and gynaecology centre called Progressive Women’s Healthcare in South Carolina. The Indian-American physician belongs to Inverness in Illinois. She pleaded guilty to two counts, each warranting a jail term of 10 years. Her sentencing is expected on October 22.
The US Attorney's office said that 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." She was earlier indicted on 13 counts of healthcare fraud.
The indictment claimed Ghosh billed government programs like Blue Cross Blue Shield and many private insurance companies for purported telemedicine visits in which she did not really speak to the patient and in-office visits and procedures in which she did not really see the patient, according to a report in CBS News.
The reproductive health specialist was also accused of filing claims for numerous false diagnoses or procedures that were not medically necessary. These included lab tests and endometrial ablations, a procedure in which the lining of the uterus is removed to reduce heavy menstrual bleeding.
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