2025 has seen several notable physical fraud cases, and the year isn’t over yet. Some of these cases have been handled through civil settlements and others have been prosecuted criminally. One involved a Texas pain management physician alleged to have falsified billings for neurostimulator procedures; another one involved a Michigan physician who received a four-year prison sentence for fraud.
Physician fraud cases have been in the news a lot lately, and coming on the heels of the recent Medicare fraud scheme implicating some of the nation’s major insurance carriers, there’s even more scrutiny of the healthcare provider billing anomalies.
If you suspect healthcare fraud, including overbilling the government, falsification of patient records, and receipt of “kickbacks,” you have the right to file a qui tam lawsuit under the False Claims Act. An experienced healthcare fraud attorney can help you understand your options and represent you in the proceedings.
Let’s look closer at some of the most notable physical fraud cases filed in 2025.
Dr. Benjamin Tiongson, Texas pain management doctor
Dr. Benjamin Tiongson faced charges of falsified billing for neurostimulator electrode implantation procedures. Dr. Tiongson practiced in the Houston, TX metro area, including Katy and Sugarland.
The federal government alleged that Dr. Tiongso had improperly billed insurance carriers for invasive surgical procedures to treat chronic pain and movement disorders that had not responded well to other treatments. In fact, the patients received electro-acupuncture treatments, a much less invasive (and less costly) procedure. Dr. Tiongson agreed to repay the government $390,082 to settle these allegations.
Dr. Sophie Toya, Michigan general physician
Dr. Sophie Toya was sentenced to four years in prison for her role in a $6.3 million Medicare fraud scheme. She and her practice were alleged to have prescribed unnecessary orthotic braces to elderly and disabled patients, and billed Medicare and Medicaid for the treatments and durable medical equipment.
The charges, brought by the U.S. Department of Justice, noted that Dr. Toya prescribed as many as 136 braces in a day, 12 braces for a single patient. In addition, the government sent in undercover agents, posing as Medicare recipients, as part of its investigation. A federal jury ultimately found Dr. Sophie Toya guilty of these charges.
In addition to her 4-year prison term, Dr. Toya was ordered to pay $3,606,935 in restitution to the government and was assessed a forfeiture of $120,475.
Dr. Mona Ghosh, suburban Chicago Ob/Gyn
Dr. Ghosh was sentenced to 10 years in federal prison for healthcare fraud. The Department of Justice (DOJ) found her guilty of billing Medicaid and private insurers for nonexistent and unnecessary services. She operated a women’s healthcare facility, specializing in obstetrics and gynecology, and from 2018 to 2022, submitted and ordered her employees to submit false claims to TRICARE, Medicaid, and several private insurers.
In addition to her 10-year term in federal prison, Dr. Ghosh was also ordered to pay $1.5 million in restitution.
Telemedicine fraud involving 36 defendants
In a large-scale enforcement action, the DOJ charged 36 individuals with submitting over $1.2 billion in fraudulent claims for telemedicine services. The fraud involved billing for unnecessary procedures, as well as illegal bribes and kickbacks for referring patients to undergo unnecessary cardiovascular and cancer genetic testing.
These cases spawned over 13 districts, and charges were filed as part of a comprehensive scheme to exploit telemedical technology. Telemedicine companies were alleged to “aggressively” incentivize practitioners to order unnecessary services.
Chesapeake Regional Medical Center indicted for enabling healthcare fraud
This case involves both the defrauding physician, Dr. Javaid Perwaiz, and the facility where he practiced, Chesapeake Regional Medical Center in eastern Virginia. The DOJ alleged that the hospital enabled and profited from Dr. Perwaiz’s fraudulent actions and inflated billing.
This isn’t the first time Dr. Perwaiz has run into legal trouble; in 1999, he was convicted of two federal felonies. In a recent complaint, Chesapeake Regional Medical Center was determined to have received $18.5 million in reimbursements from healthcare benefit programs for procedures performed by Dr. Perwaiz at the facility. From 2010 to 2019, Dr. Perwaiz (and other unnamed defendants) were alleged to have billed Medicare, TRICARE, and private insurers for unnecessary induced deliveries. The complaint alleged that Dr. Perwaiz did not personally perform the procedures, and in fact, was present at the hospital to perform other surgeries.
Physician Fraud and the False Claims Act
Some of these cases were filed under the federal False Claims Act, which permits anonymous whistleblowers to file a report for healthcare fraud. Under the False Claims Act, whistleblowers file a lawsuit and report the fraud to the government, which then investigates. If the fraud exists and the government recovers money, the whistleblower is entitled to a portion of the recovery.
Do you have information about healthcare fraud and want to file a qui tam complaint under the False Claims Act? Call Griffin Durham today at (404) 891-9150 to discuss your legal options.
