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Date: 08-04-2023
Case Style:
Case Number: 1:22-cr-00146
Judge: James K. Bredar
Court: United States District Court for the District of Maryland (Baltimore County)
Plaintiff's Attorney: United States Attorney’s Office in Baltimore
Defendant's Attorney: Gregg Bernstein and Marten Himeles
Description: Baltimore, Maryland criminal defense lawyers represented Defendant charged with health car fraud.
Ron Elfenbein, M.D., age 49, of Arnold, Maryland, was found guilty on five counts of healthcare fraud for submitting over $15 million in false and fraudulent claims to Medicare and other insurers for patients who received COVID-19 tests at sites operated by the defendant. Elfenbein is the first doctor convicted at trial by the Justice Department for health care fraud in billing for office visits in connection with patients seeking COVID-19 tests.
The conviction was announced by United States Attorney for the District of Maryland Erek L. Barron; Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; Special Agent in Charge Maureen Dixon for the Department of Health and Human Services Office of Inspector General (HHS-OIG); Special Agent in Charge Christopher Dillard of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service - Mid-Atlantic Field Office; Special Agent in Charge Thomas Sobocinski for the FBI Baltimore Field Office, and Deputy Assistant Inspector General for Investigations Conrad J. Quarles, Office of the Inspector General (OPM-OIG).
According to the evidence presented at his three-week trial, Elfenbein owned and operated Drs ERgent Care, LLC, d/b/a First Call Medical Center and Chesapeake ERgent Care. Drs ERgent care operated drive-through COVID-19 testing sites in Anne Arundel and Prince George’s Counties. Elfenbein instructed the employees of Drs ERgent Care that, in addition to billing for the COVID-19 test, the employees were to bill for high-level evaluation and management visits. In reality, these visits were not provided to patients as represented. Rather, Elfenbein instructed his employees that the patients were “there for one reason only – to be tested,” that it was “simple and straightforward,” and that the providers were “not there to solve complex medical issues.” Many of these patients were asymptomatic, were getting tested for COVID-19 for their employment requirements, or who were getting tested for COVID-19 so that they could travel. Elfenbein, through Drs ERgent Care, submitted or caused the submission of claims totaling more than $15 million to Medicare and other insurers for these high-level office visits.
Elfenbein faces a maximum sentence of 10 years in federal prison for each of the five counts of healthcare fraud for which he was convicted. Chief U.S. District Judge James K. Bredar has scheduled sentencing for November 7, 2023 at 4:00 p.m.
The Department of Justice needs the public’s assistance in remaining vigilant and reporting suspected fraudulent activity. To report suspected fraud, contact the National Center for Disaster Fraud (NCDF) at (866) 720-5721 or file an online complaint at: https://www.justice.gov/disaster-fraud/webform/ncdf-disaster-complaint-form. Complaints filed will be reviewed at the NCDF and referred to federal, state, local, or international law enforcement or regulatory agencies for investigation.
United States Attorney Erek L. Barron and Assistant Attorney General Kenneth A. Polite commended the HHS-OIG, DCIS, the FBI, and OPM-OIG for their work in the Elfenbein investigation. Mr. Barron and Mr. Polite thanked Assistant U.S. Attorney Matthew P. Phelps and Trial Attorney D. Keith Clouser of the Justice Department’s Fraud Section, who are prosecuting the case.
Outcome: Defendant was found guilty.
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Defendant's Experts:
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