Federal Appeals Court Reinstates Conviction of Maryland Doctor

Legal proceedings in a healthcare fraud case.

News Summary

A federal appeals court has overturned a previous acquittal of Dr. Ron Elfenbein, a Maryland physician accused of defrauding Medicare out of $15 million related to COVID-19 testing. The court upheld a jury’s finding of guilt on five counts of health care fraud, stating there was sufficient evidence against him. Elfenbein, who operated multiple urgent care facilities, was accused of overbilling Medicare and falsifying records. Although the conviction was reinstated, the court granted him a new trial, while his medical license remains valid amid ongoing investigations into health care fraud.

Baltimore, Maryland – A federal appeals court has reinstated the conviction of Dr. Ron Elfenbein, a Maryland physician accused of defrauding Medicare out of $15 million in a health care fraud scheme tied to COVID-19 testing. This decision overturns an earlier court ruling that had acquitted him over insufficient evidence.

In 2023, Elfenbein, 51, was found guilty by a jury on five counts of health care fraud in U.S. District Court in Baltimore. Prosecutors argued that he excessively billed Medicare for brief office visits and used falsified medical records to support his claims. Elfenbein operated several urgent care facilities, including Drs ERgent Care LLC, which ran under the names First Call Medical Center and Chesapeake ERgent Care in Anne Arundel and Prince George’s counties. He also managed an urgent care center at the Baltimore-Washington International Thurgood Marshall Airport, where he offered COVID-19 testing.

The fraudulent activity reportedly centered on five specific patient visits that took place between March 5 and May 12, 2021. Judge James K. Bredar, the presiding U.S. Senior District Judge, had initially ruled in favor of Elfenbein, stating that the prosecution did not provide enough evidence to justify the conviction and asserting that exploiting broad definitions in regulatory language was not a criminal offense. His decision came four months after the trial concluded.

However, a three-judge panel from the U.S. Court of Appeals for the 4th Circuit disagreed with the acquittal. They maintained that evidence presented during the trial was sufficient for the jury to find Elfenbein guilty. Circuit Judge Julius N. Richardson pointed out the importance of the jury’s capacity to interpret the testimony and assess the credibility of witnesses.

The appeals court did, however, affirm Judge Bredar’s earlier ruling to grant Elfenbein a new trial, allowing for some deference to the lower court’s decision. After the ruling, neither Dr. Elfenbein nor his attorney, Martin Himeles Jr., could be reached for comments.

Despite the ongoing legal proceedings, Elfenbein’s medical license remains valid, as confirmed by the Maryland Board of Physicians. At the time of his indictment in 2022, then-U.S. Attorney Erek Barron accused him of leveraging the COVID-19 pandemic for personal financial enrichment. Barron emphasized a commitment to pursuing fraud cases connected to the pandemic, with ongoing investigations into medical practices exploiting the public health crisis.

As of the latest information, it is unclear whether federal prosecutors will move forward with a new trial against Elfenbein following the appeals court’s ruling. The case highlights continuing scrutiny over health care practices and the integrity of medical professionals during challenging times, such as the COVID-19 pandemic.

This development underscores the broader implications of health care fraud, especially during periods of crisis. The legal proceedings involving Dr. Elfenbein serve as a reminder of the critical enforcement efforts being undertaken to maintain accountability in the healthcare sector.