News Summary
A federal appeals court has reinstated Dr. Ron Elfenbein’s conviction for health care fraud totaling $15 million, reversing a prior acquittal. The court found sufficient evidence for the jury’s original verdict, stating that Dr. Elfenbein exploited the health care system during the COVID-19 pandemic by billing improperly and falsifying medical records. Despite the reinstatement, the court granted him a new trial. The case is significant for its implications on health care fraud enforcement amid the ongoing public health crisis.
Baltimore, Maryland – A federal appeals court has reinstated the conviction of Dr. Ron Elfenbein for health care fraud amounting to $15 million, reversing a previous acquittal in a significant case involving alleged fraudulent billing during the COVID-19 pandemic. The decision was made by a three-judge panel from the U.S. Court of Appeals for the 4th Circuit, which found that there was sufficient evidence for the jury’s original verdict.
Dr. Elfenbein, 51, was previously convicted in 2023 by a jury in U.S. District Court in Baltimore on five counts of health care fraud, related to excessive billing practices. Federal prosecutors charged him with improperly billing Medicare for brief patient visits and submitting falsified medical records that exaggerated the complexity of the services provided, specifically during the pandemic. The charges stemmed from five specific patient visits that occurred between March 5 and May 12, 2021.
The court proceedings revealed that Dr. Elfenbein owned and operated Drs ERgent Care LLC under the names First Call Medical Center and Chesapeake ERgent Care, located in Anne Arundel and Prince George’s counties. He also managed an urgent care center at Baltimore-Washington International Thurgood Marshall Airport, where he was involved in administering COVID-19 tests. Allegations suggested that he exploited the health care system during a time of crisis for financial gain.
Following the jury’s conviction, U.S. Senior District Judge James K. Bredar acquitted Dr. Elfenbein over four months later, citing insufficient evidence to support the fraud allegations. Judge Bredar emphasized that merely taking advantage of vague definitions in healthcare regulations does not constitute a criminal offense, indicating that the flexible nature of these regulations allows for various provider interpretations.
However, the appeals court took a different stance, affirming that there was enough evidence for the jury to uphold its conviction. Circuit Judge Julius N. Richardson underscored the importance of the jury’s role in evaluating testimony and deciding which evidence was credible, countering the lower court’s conclusions. While the appeals court reinstated the conviction, it upheld Judge Bredar’s previous decision to grant Dr. Elfenbein a new trial, granting him judicial deference in that particular matter.
Neither Dr. Elfenbein nor his attorney, Martin Himeles Jr., could be reached for comments following the appellate ruling. Despite the legal proceedings, Dr. Elfenbein’s medical license remains active, as confirmed by the Maryland Board of Physicians.
In the backdrop of this case, then-U.S. Attorney Erek Barron highlighted the gravity of the situation back in 2022, stating that fraud cases, particularly those related to the COVID-19 pandemic, were a priority for the prosecution. Barron emphasized the commitment to pursuing health care fraud amid widespread exploitation during the public health emergency.
As of now, it remains unclear whether federal prosecutors will initiate a new trial against Dr. Elfenbein following the reinstatement of his conviction. The case has garnered attention due to its implications for health care fraud enforcement and ethical practices within the medical community, particularly in the context of the ongoing pandemic.
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Additional Resources
- The Baltimore Banner
- CBS News
- Baltimore Sun
- Voice News
- New York Times
- Wikipedia: Healthcare Fraud
- Encyclopedia Britannica: Health Care Fraud
Author: STAFF HERE INDIANAPOLIS WRITER
INDIANAPOLIS STAFF WRITER The INDIANAPOLIS STAFF WRITER represents the experienced team at HEREIndianapolis.com, your go-to source for actionable local news and information in Indianapolis, Marion County, and beyond. Specializing in "news you can use," we cover essential topics like product reviews for personal and business needs, local business directories, politics, real estate trends, neighborhood insights, and state news affecting the area—with deep expertise drawn from years of dedicated reporting and strong community input, including local press releases and business updates. We deliver top reporting on high-value events such as the Indianapolis 500, Indy Jazz Fest, and the Indiana State Fair. Our coverage extends to key organizations like the Indy Chamber and Visit Indy, plus leading businesses in motorsports and healthcare that power the local economy such as Indianapolis Motor Speedway and IU Health. As part of the broader HERE network, we provide comprehensive, credible insights into Indiana's dynamic landscape.
