Doctor removed thin layer of tissue lining patients’ uteruses when unnecessary, feds say
A doctor performed medically unnecessary procedures on her patients as part of a $796,000 health care scheme she ran at her suburban clinic outside of Chicago, Illinois, according to federal authorities.
Those procedures included endometrial ablations, records show, which is when “a thin layer of tissue (endometrium) that lines the uterus” is removed. This is typically done to reduce, or completely stop, heavy menstrual bleeding in women who do not plan to have children, according to Johns Hopkins Medicine.
Other medically unnecessary procedures the doctor is accused of performing included endometrial biopsies and tests for sexually transmitted diseases, prosecutors said.
Mona Ghosh, 50, was recently indicted on 13 counts of health care fraud, according to a March 14 news release from the U.S. Attorney’s Office for the Northern District of Illinois.
The defense attorney representing Ghosh did not immediately respond to a request for comment from McClatchy News on March 15.
Authorities said Ghosh, of Inverness, defrauded TRICARE, Medicaid and private insurance companies from February 2018 to April 2022. She did so while working as a licensed physician at Progressive Women’s Healthcare, S.C. in Hoffman Estates, authorities said. Records show the clinic has since closed.
“Health care providers who submit fraudulent claims for unnecessary and non-rendered services not only waste valuable taxpayer dollars, but also undermine the trust and confidence of their patients,” Special Agent in Charge Mario Pinto said in the release.
In addition to billing for medically unnecessary procedures performed on her patients, authorities said the doctor submitted reimbursement claims for work she never did.
“These included claims for purported telemedicine visits when Ghosh did not speak to the patient, claims for office visits and procedures when Ghosh did not see the patient (and) claims for procedures predicated on false diagnosis,” according to the release.
Prosecutors said she received about $796,000 in fraudulent payments through the scheme.
“Targeting government and private healthcare programs relied on by the public to maintain their well-being is a serious crime,” Acting U.S. Attorney Pasqual said in the release. “In addition to submitting false claims, the allegation that defendant performed medically unnecessary procedures to enrich herself is particularly disturbing. This office will continue to work closely with our law enforcement partners to prosecute those who steal from healthcare programs and who needlessly put patients at risk.”
If you believe you or someone you know were a victim of Ghosh, or if you have additional information, authorities ask you to email the FBI at mg@fbi.gov.
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