In a significant legal settlement, Dr. Ameet Vohra and his companies, including Vohra Wound Physicians Management LLC, have agreed to pay $45 million to resolve allegations of defrauding Medicare. The Justice Department announced that it was alleged Vohra billed for unnecessary surgical procedures and manipulated electronic healthcare records to overbill Medicare.
Operating across the nation, Vohra Wound Physicians provided specialty care in nursing homes and skilled nursing facilities. According to the allegations, physicians under Vohra's command were encouraged to bill Medicare for surgical debridement procedures—whether they were necessary or not. On some occasions, when only routine non-surgical wound management had been performed, it was revealed that Vohra's electronic health record system ensured Medicare was charged for the higher-reimbursed surgical procedures. Assistant Attorney General Brett A. Shumate described the situation by stating, "Providers that manipulate electronic health records systems to drive inappropriate utilization or billing of Medicare services undermine the integrity of the Medicare program and waste taxpayer dollars," as noted by the Justice Department.
This settlement also includes a five-year Corporate Integrity Agreement (CIA) with the Department of Health and Human Services' Office of Inspector General. As part of the CIA, Vohra is expected to maintain a compliance program and undergo regular reviews. On top of scheming to bilk funds from a program meant to serve the country’s seniors, the company now faces the task of re-establishing its ethical bearings under close government scrutiny.
U.S. Attorney Jason A. Reding Quiñones for the Southern District of Florida, one of the offices involved in the coordinated legal effort, emphasized the detriment caused to the public, "When corporations design systems to inflate profits at taxpayer expense, they are stealing from the American people." Vohra's settlement, which brings to light the need for vigilance against healthcare fraud, according to the same press release.
Tips from the public have been crucial in uncovering fraudulent activity, aiding the government's efforts in combating healthcare fraud. The Department of Health and Human Services urges anyone with information on potential fraud, waste, abuse, and mismanagement to contact them at 800-HHS-TIPS (800-447-8477). This case was driven by a joint investigation from the Justice Department’s Civil Division, the U.S. Attorney’s Offices for the Southern District of Florida and the Southern District of Georgia, and the Department of Health and Human Services, Office of Inspector General.
