A federal judge has taken the unusual step of throwing out a jury's conviction of a prominent Maryland doctor who submitted millions of dollars in fraudulent insurance claims for COVID-19 testing.
In a detailed 90-page decision, Chief Judge James K. Breder of the U.S. District Court for the District of Maryland ruled that the government found Arnold emergency room physician Ron Elfenbein, M.D., guilty of filing $15. It was stated that the standards were not met. The emergency center he runs handles over a million fraudulent tests.
He was one of several people indicted on fraud charges by the U.S. Department of Justice during the coronavirus pandemic, but is the first to be convicted of testing-related fraud at trial.
Breder noted that the move was unusual, but that Elfenbein, an early advocate of tests for deadly infectious diseases, had improperly “improved” those tests and made Medicare and other insurance companies unable to test them. He said the government had not presented enough evidence to conclude beyond a reasonable doubt that he had been charged costs. He had no obligation to repay.
“In this context, it is not a crime to take advantage of vague definitions or obvious loopholes, as when citizens prepare their tax returns,” Breder wrote in his opinion. “The public, including health care workers, can be held criminally liable for doing only what the technical regulations reasonably permit, even if it appears to give them an undue advantage. It cannot be questioned.”
Elfenbein was indicted last year on five counts of medical fraud for conducting tests through his company Drs ERgent Care, which operates First Call Medical Center and Chesapeake ERgent Care in Anne Arundel and Prince George's counties. , not working in the emergency department. .
It also won a temporary contract to operate an urgent care center offering testing at Baltimore-Washington International Thurgood Marshall Airport. For this accomplishment, he was awarded a Citation by the then-Gov. Larry Hogan.
Drs ERgent Care is no longer in operation. Elfenbein's attorney, Martin S. Jimeles Jr., said he expects Elfenbein to seek full reinstatement of his medical license and return to emergency medicine. He has had privileges at various hospitals on the Eastern Shore and Southern Maryland.
The Maryland State Board of Medical Examiners notes that his enrollment in the Maryland Medicaid program was terminated in August following his conviction, but still lists his license as valid. Elfenbein could have received up to 10 years in prison.
“We are pleased that our client, who we knew from the beginning was innocent, was proven innocent,” Jimeles said.
“For too long he has lived under the cloud of government accusations and investigations, and in the court's very clear, comprehensive and thorough opinion, the evidence presented by the government simply proves his guilt. “It turned out that it wasn't proven,” he said. “He can now get back to doing what he loves to do: helping patients who need his help, compassion and support.”
New trials are not automatically granted. The government will likely need to appeal and seek a new trial.
One person who appears to be questioning the move for a new trial is Rod Rosenstein, a former federal prosecutor from Maryland who served as assistant attorney general in the Trump administration. He was not involved in the Elfenbein incident.
“Judge Breder's opinion is a masterpiece,” he said. “This case sends a strong message to leaders in the U.S. Attorney's Office and the Justice Department's Criminal Division that they should be skeptical of prosecuting people for allegedly violating vague federal regulations. may be better handled through civil enforcement.”
The U.S. Attorney's Office had no comment.
Baltimore Banner reporter Justin Fenton contributed to this article.
