The DOJ recently filed a complaint against Vohra Wound Physicians Management LLC and its owner, Dr. Ameet Vohra (collectively “Vohra”), for violating the False Claims Act (“FCA”).
According to the complaint, Vohra Wound Physicians engaged in a nationwide scheme to submit false claims to Medicare for surgical debridement procedures that were either medically unnecessary or not performed as billed. The accusations include the misuse of proprietary Electronic Medical Record (EMR) software to automatically classify procedures as surgical, regardless of their actual nature. Additionally, the company is accused of pressuring physicians to meet revenue-driven debridement targets, rather than basing decisions on patient care needs. The DOJ also claims that Vohra’s EMR software improperly applied Modifier 25 to billing codes, leading to Medicare charges for exams that were not separately billable from surgical debridement procedures on the same day. It alleges that the software automatically added Modifier 25 without determining if it was appropriate, resulting in claims for non-payable evaluation and management (E&M) services.
Deputy Assistant Attorney General Michael D. Granston of the Justice Department’s Civil Division commented that “[p]roviders 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 […] The Justice Department will hold accountable providers who prioritize their own enrichment over the medical needs of their patients.” This complaint serves as a stark reminder of the far-reaching implications of the False Claims Act.
The attorneys at Chilivis Grubman also represent clients of all types and sizes in connection to False Claims Act investigations and litigation. If you need assistance with such a matter, please contact us today.