Doctor Convicted for COVID-19 Health Care Fraud Scheme

He submitted more than $15 million in false and fraudulent claims to Medicare and a commercial insurer.

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A federal jury in Baltimore convicted a Maryland doctor today for submitting more than $15 million in false and fraudulent claims to Medicare and a commercial insurer for patients who received COVID-19 tests at his testing sites.

According to court documents and evidence presented at trial, Ron Elfenbein, 49, of Arnold, was an owner and the medical director of Drs ERgent Care LLC, dba First Call Medical Center and Chesapeake ERgent Care. Drs ERgent Care operated multiple 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 COVID-19 tests, 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.”

Elfenbein ordered these high-level visits to be billed for all patients, including those who were asymptomatic, who were getting tested for COVID-19 for their employment requirements, and who were being tested for COVID-19 so that they could travel. Elfenbein, through Drs ERgent Care, caused the submission of millions of dollars in claims to Medicare and a commercial insurer for tens of thousands of high-level visits that were not provided as represented and were ineligible for reimbursement.

The jury convicted Elfenbein of five counts of health care fraud. He is scheduled to be sentenced on Nov. 7 and faces a maximum penalty of 10 years in prison on each count. 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. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

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