Illinois Doctor Faces Sentencing for Defrauding Medicaid and Insurance Providers

A suburban Chicago doctor is awaiting sentencing after pleading guilty to a large-scale health care fraud scheme involving both Medicaid and private insurance companies. Dr. Mona Ghosh, formerly the owner of Progressive Women’s Healthcare in Hoffman Estates, admitted to submitting fraudulent claims for services that were either never provided or medically unnecessary. The fraudulent activity included both in-person and telehealth appointments.

Ghosh’s case, being heard at the Dirksen Federal Building in Chicago, may result in a sentence of up to 20 years in federal prison. Her plea deal acknowledged over $1.5 million in improper reimbursements. Two patients have already testified, describing how Ghosh misrepresented appointment details and pressured them into unnecessary procedures, eroding their trust in the medical system.

The sentencing is expected to last two days, with more witness testimonies anticipated. Ghosh has remained present in the courtroom as former patients recount their experiences. The closure of her practice marks the end of what prosecutors call a years-long pattern of deceptive billing practices.

The case serves as a reminder to insurance adjusters of the importance of vigilance in monitoring provider billing behavior, particularly when claims involve both public and private payer systems.