United States Files False Claims Act Complaint Against Vohra Wound Physicians Management and Its Owner Alleging False Claims for Wound Care Services

The United States filed a complaint under the False Claims Act against Vohra Wound Physicians Management LLC (Vohra) and its founder and majority owner, Dr. Ameet Vohra, for allegedly causing the submission of false claims to Medicare for overbilled and medically unnecessary wound care services. Vohra is one of the nation’s largest specialty wound care providers and contracts with hundreds of nursing homes and skilled nursing facilities throughout the country to provide wound care services to those facilities’ patients at their bedside.

“Providers that overbill the government for services, or bill for services that are unreasonable or medically unnecessary, undermine the integrity of the Medicare program and waste taxpayer dollars,” said Deputy Assistant Attorney General Michael D. Granston of the Justice Department’s Civil Division. “The Justice Department will hold accountable providers who prioritize their own enrichment over the medical needs of their patients.”

“This office is committed to protecting our nation’s seniors and the important federal programs that support them,” said U.S. Attorney Hayden O’Byrne for the Southern District of Florida. “When providers seek to misappropriate public funds for private gain, we will work with our partners to pursue those responsible.”

“Healthcare fraud is harmful to all consumers, artificially and unnecessarily increasing the costs of care for everyone,” said Acting U.S. Attorney Tara M. Lyons for the Southern District of Georgia. “Identifying and ending fraudulent billing activity is essential to keeping healthcare costs manageable for patients and for taxpayer-funded healthcare programs.”

According to the United States’ complaint, Vohra and Dr. Vohra knowingly engaged in a nationwide scheme to falsely bill Medicare for surgical debridement procedures to maximize revenue.  Debridement is a procedure to remove impediments to healing from a wound, such as dead or unhealthy tissue, and can be accomplished in several ways including nonsurgical and surgical methods.

The complaint alleges that the defendants pursued their fraudulent scheme in three primary ways. First, Vohra created a proprietary Electronic Medical Record (EMR) software that was programmed to bill debridements as surgical procedures even when they were not. Second, Vohra hired physicians without wound care expertise and provided training that omitted relevant Medicare payment rules and intentionally conflated the definitions of surgical and nonsurgical debridement procedures. Third, Vohra set corporate debridement targets based solely on revenue goals and pressured its physicians to meet those targets. As a result, Vohra allegedly caused the submission of claims for surgical debridement services that were not medically necessary and used billing codes that represented more complex procedures than were actually performed (commonly referred to as “upcoding”).   

The complaint also alleges that the defendants programmed Vohra’s proprietary EMR software to improperly apply the Modifier 25 billing code and charge Medicare for exams that were not separately billable from surgical debridement procedures performed on the same day. Because surgical debridements are billed as global surgical packages and include payment for an examination, evaluation and management (E&M) services are only payable on the same day if a significant service is performed that is separately identifiable from the surgical debridement as signified by Modifier 25. According to the United States’ complaint, Vohra’s proprietary EMR software automatically added Modifier 25 to its E&M claims without regard to whether the modifier was appropriate, thereby causing the submission of claims for E&M services that were not payable.

This matter is being handled by the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Offices for the Southern District of Florida and Southern District of Georgia.  Investigative support is being provided by the Department of Health and Human Services (HHS) Office of Inspector General. The lawsuit was filed in the U.S. District Court for the Southern District of Florida and is captioned United States v. Dr. Ameet Vohra; Vohra Wound Care Management, LLC; and VHS Holdings, PA, No. 25-cv-21570 (S.D. Fla.).

Trial Attorney Kirsten Mayer of the Civil Division’s Fraud Section, Assistant U.S. Attorney Ryan Grover for the Southern District of Georgia, and Assistant U.S. Attorney Christopher Cheek for the Southern District of Florida are handling the matter.

The investigation and prosecution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the HHS at 800-HHS-TIPS (800-447-8477).

The claims asserted in the government’s complaint are allegations only, and there has been no determination of liability.