In November 2025, the Department of Justice announced a $45 million settlement with Vohra Wound Physicians Management, LLC, and its founder, Dr. Ameet Vohra. Vohra operated one of the largest wound care services in the country, treating patients in nursing homes and skilled nursing facilities nationwide.
The government alleged that Vohra ran a systematic scheme to defraud Medicare by programming its own electronic health record and billing software to ensure that Medicare was always billed for higher-reimbursed surgical procedures, regardless of what physicians performed. The software also auto-populated clinical documentation to make it appear that surgical care had been provided when it had not.
As Assistant Attorney General Brett Shumate noted in connection with the settlement, providers that manipulate electronic health records systems to drive inappropriate billing of Medicare services undermine the integrity of the program and waste taxpayer dollars.
How Electronic Health Records Became a Tool for Fraud
Electronic health records were developed to improve the accuracy and continuity of patient care. When the federal government began incentivizing EHR adoption through the Medicare and Medicaid EHR Incentive Programs, widespread implementation followed quickly. That adoption created a new vulnerability: because billing codes are often generated automatically based on documentation entered into the EHR, a system that is configured or manipulated to produce favorable documentation can generate false claims on a massive scale, across thousands of patients, with minimal manual intervention by individual providers.
The Vohra case illustrates how this works in practice. According to the government’s complaint, Vohra’s EHR restricted physicians’ ability to enter free-text clinical notes, auto-populated templated documentation, and calculated procedure metrics in ways that consistently supported billing for the higher-paying surgical code. Many of the physicians using the system did not know that it was automatically coding their work as surgical debridement regardless of what they performed. The software was doing the upcoding for them.
Why EHR Manipulation Violates the False Claims Act
Every claim submitted to Medicare includes a certification that the information in the claim is accurate. That certification covers not just the dollar amount, but also the underlying documentation that supports the code billed. When an EHR is configured to generate documentation that does not reflect the care provided, every claim produced by that system is potentially a false claim under the False Claims Act.
The government can recover up to three times the amount it was improperly paid, plus additional per-claim penalties. In cases involving EHR-driven fraud, where the same misconfiguration affects every patient encounter processed through the system, the volume of affected claims can be enormous. The Vohra complaint covered a nationwide operation servicing hundreds of facilities, and the $45 million settlement reflected that scale.
EHR-related fraud can take several forms beyond the Vohra model:
- Upcoding through pre-configured templates that default to higher-reimbursement codes regardless of clinical documentation
- Auto-population of documentation fields that manufacture the appearance of services not actually performed or not performed at the level billed
- EHR vendor kickbacks, where vendors pay healthcare providers to recommend their software to other users, potentially influencing how those systems are configured and used
- False certification of EHR capabilities, where vendors misrepresent what their software can do to obtain federal certification under incentive programs
- Copy-paste or cloning of patient records, where a prior visit’s documentation is carried forward wholesale into a new visit without reflecting the patient’s current condition
The Role of Whistleblowers in EHR Fraud Cases
EHR fraud is particularly difficult for the government to detect from the outside. The false documentation is embedded within the system and often looks facially consistent. The people most likely to notice the problem are those working inside the organization: physicians who recognize that what they documented does not match how the system coded their work, billing staff who see patterns that do not align with clinical reality, or compliance personnel who raise concerns internally and are ignored.
The False Claims Act’s qui tam provisions allow these individuals to file a lawsuit on behalf of the federal government and receive a portion of any government recovery. EHR fraud cases have produced some of the largest qui tam recoveries in healthcare enforcement history, including a $155 million settlement with eClinicalWorks and a $145 million settlement with Practice Fusion, both of which were initiated by whistleblowers with direct knowledge of how those systems operated.
People who may have relevant information about EHR-driven billing fraud include:
- Physicians who have noticed that their documented care does not match the codes their employer submitted to Medicare or Medicaid
- Nurses, therapists, or other clinicians who recognize that auto-populated notes do not reflect the services they provided
- Billing and coding staff who are aware that the EHR defaults to higher-reimbursement codes regardless of what the record supports
- Compliance officers or health information managers who have flagged these issues internally without resolution
- Software developers or IT staff with knowledge of how an EHR was deliberately configured to generate favorable documentation or codes
Speak With a Whistleblower Attorney
If you have knowledge of an EHR system that has been programmed or configured to inflate billing, you may have the basis for a qui tam lawsuit under the False Claims Act. A whistleblower attorney at Keller Grover can evaluate what you know and advise you on how to come forward. Contact our legal team today to discuss your situation and your rights.