At this stage of the game, pretty much no one wants to discuss the COVID-19 pandemic. While it has never officially been declared over, the pandemic was a troubling time for us all. That is putting it mildly. Hundreds of thousands of lives were lost. In addition to the deaths caused by the coronavirus, the entire process of going through lockdowns and following restrictions continues to have impacts on our mental health.
The fact that so much fraudulent activity has emanated from the pandemic hasn’t helped matters either. The story of COVID-19 continues to be a disturbing tale. While it is not one we wish to dwell on, it’s important to note that instances of pandemic-related fraud are still coming to light. This is evidenced by the District of Maryland branch of the U.S. Attorney's Office. It announced a recent conviction last Friday.
Dr. Ron Elfenbein was found guilty of COVID-19-related healthcare fraud.
According to the U.S. Attorney's Office, the 49 year-old Arnold, Maryland resident was convicted for five counts of healthcare fraud. Elfenbein submitted over $15 million worth of false and fraudulent claims to Medicare and other insurers. The claims were for patients who received COVID-19 tests at sites that he operated.
The report notes that Elfenbein has made history. He 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.
Elfenbein owned and operated Drs ERgent Care and Chesapeake ERgent Care.
Evidence presented at Elfenbein’s three-week trial showed that Drs ERgent Care conducted business under the name First Call Medical Center. The facility operated drive-through COVID-19 testing sites in both Anne Arundel and Prince George’s Counties. Elfenbein instructed the employees of Drs ERgent Care to not just bill for COVID-19 tests but also bill for high-level evaluation and management visits.
“In reality, these visits were not provided to patients as represented,” reads the report, “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.’”
Many of the patients were asymptomatic.
For the most part, patients were getting tested for COVID-19 because of employment requirements. In some cases, individuals were getting tested for COVID-19 so that they could travel. Through Drs ERgent Care, Elfenbein submitted or caused the submission of claims that totaled more than $15 million to Medicare and other insurers for these high-level office visits.
Elfenbein faces a maximum of 50 years in prison. He can receive a sentence of 10 years in federal prison for each of the five counts of healthcare fraud for which he was convicted.
Are you an attorney who is currently working a healthcare fraud case?
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