Baltimore, Maryland – Dr. Ron Elfenbein, a 49-year-old physician from Arnold, Maryland, has been found guilty of five counts of healthcare fraud for submitting over $15 million in false and fraudulent claims to Medicare and other insurers. The claims were related to patients who received COVID-19 tests at testing sites operated by the defendant. This marks the first conviction at trial by the Justice Department for healthcare fraud involving billing for office visits in connection with patients seeking COVID-19 tests.
United States Attorney announced the conviction for the District of Maryland, Erek L. Barron, and Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. The investigation was conducted by several agencies, including the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Department of Defense Office of Inspector General, the Defense Criminal Investigative Service – Mid-Atlantic Field Office, the FBI Baltimore Field Office, and the Office of the Inspector General (OPM-OIG).
During the three-week trial, evidence was presented that Elfenbein owned and operated Drs ERgent Care, LLC, doing business as First Call Medical Center and Chesapeake ERgent Care. The facilities provided drive-through COVID-19 testing in Anne Arundel and Prince George’s Counties. Prosecutors revealed that Elfenbein instructed the employees to bill for high-level evaluation and management visits in addition to the COVID-19 test, even though these visits were not provided to patients as claimed. Instead, the patients were primarily seeking COVID-19 tests for employment requirements or travel purposes, and many were asymptomatic.
Instructing his employees that the patients were only there for testing, Elfenbein emphasized that the process was straightforward and that the providers were not required to address complex medical issues. Despite this, through Drs ERgent Care, he submitted or caused the submission of claims totaling more than $15 million to Medicare and other insurers for these high-level office visits.
The doctor now faces a maximum sentence of 10 years in federal prison for each of the five counts of healthcare fraud for which he was convicted. The sentencing is scheduled for November 7, 2023, at 4:00 p.m., before Chief U.S. District Judge James K. Bredar.
In response to this case and other potential fraudulent activities, the Department of Justice urges the public to remain vigilant and report any suspected fraudulent activity. Those with information can contact the National Center for Disaster Fraud (NCDF) at (866) 720-5721 or file an online complaint at the following link: https://www.justice.gov/disaster-fraud/webform/ncdf-disaster-complaint-form. Reports submitted will be carefully reviewed by the NCDF and referred to relevant law enforcement or regulatory agencies for further investigation.
United States Attorney Erek L. Barron and Assistant Attorney General Kenneth A. Polite praised the HHS-OIG, DCIS, FBI, and OPM-OIG for their diligent work in the Elfenbein investigation. They also thanked Assistant U.S. Attorney Matthew P. Phelps and Trial Attorney D. Keith Clouser from the Justice Department’s Fraud Section, who handled the case’s prosecution.
Dr. Elfenbein’s conviction is a significant step in combating healthcare fraud related to COVID-19 testing. The Justice Department’s continued efforts in pursuing such cases highlight the commitment to protecting public funds and ensuring the integrity of the healthcare system.
