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Maryland doctor charged with defrauding Medicare and other insurers of $1.5 million

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A prominent Maryland doctor overseeing coronavirus testing at Baltimore-Washington Marshall International Airport and other sites in Anne Arundel and Prince George counties was charged on Tuesday, accused by federal prosecutors of overcharging Medicare and other insurers over $1.5 million.

Ron Elfenbein, 47, has been a frequent guest on local and national television news during shows about coronavirus testing, treatments and vaccines. At a groundbreaking ceremony in August for the new clinic inside BWI, Governor Larry Hogan (right) presented him with a citation for his efforts during the pandemic.

Now, federal prosecutors say that under Elfenbein’s direction, clinics billed Medicare and other insurers for coronavirus testing in combination with ‘more lucrative, but medically unnecessary’ services, according to an indictment. of the grand jury. These services “allegedly were 30 minutes or more in duration, or involved moderate or high levels of medical decision-making, but did not in fact take place as depicted,” the indictment states.

The indictment alleges Elfenbein knew many patients were being seen for less than five minutes, but ordered staff members to charge for higher level services anyway, claiming they were “the” bread and butter “how we get paid”.

An attorney for Elfenbein, Mike Lawlor, disputed those charges. “At the start of the pandemic, Dr. Ron Elfenbein rallied his doctor’s office in a time of global fear, to be one of the leading providers of coronavirus testing and treatment in the community,” Lawlor said in an email. “…A trial in this case will prove not only that Dr. Elfenbein is innocent of the charges hastily brought by the government, but that during an unprecedented time of need, Dr. Elfenbein and his team saved the lives of many Marylanders.”

The indictment, which charges Elfenbein with three counts of health care fraud, identifies him as the owner and medical director of Drs ERgent Care, a company that also does business as First Call Medical Center and Chesapeake ERgent Care.

Drs ERgent Care was launched in 2015 and listed as his “main office” the home address of Maryland Del. Sid A. Saab (R-Anne-Arundel), who was listed as a registered agent, according to company records. The following year, the address changed and Elfenbein became a registered agent.

Saab, who attended the inauguration of the BWI, registered in January in a mandatory financial statement as co-owner of Gambrills Medical Management, which the disclosure says operates First Call Medical Center Gambrills. The latter company operates the BWI Clinic, according to records maintained by the Maryland Board of Public Works. The clinic, inside the main terminal near Concourse C, offers emergency care, coronavirus testing and vaccinations, and other services.

A LinkedIn page for Saab, State delegate since 2015, lists him as co-owner of a fitness center, president of a real estate company and managing director of a company involved in “precious metals recycling” linked to the same Gambrills address as First Call Medical Center. Dan Hazelwood, a spokesman for Saab’s political campaign, said Saab had no comment.

A job offer within the past year associated with First Call Medical Center for someone to oversee a center offering monoclonal antibody infusions, covid-19 treatment, said the position would report to Saab and Elfenbein.

A member of the House Health and Government Operations Committee, Saab recently filed for the state Senate. He said in the financial disclosure: “First Call Medical Center had a contract with the Department of Health regarding coronavirus testing and treatment.”

He owns between 25 and 49 percent of Gambrills Medical Management, according to his disclosure. “Neither Gambrills Medical Management nor First Call has received state funding. I was not involved in any negotiations with the state,” the disclosure said.

Connor Ferguson, whose LinkedIn page lists him as the managing partner of First Call Medical Center, warned a reporter when reached by phone on Friday: “Be very careful – as this is an independent company, with Dr. Elfenbein – involving First Call, so all I’ll say is because he operates a professional corporation under the direction of Drs ERgent Care.

When asked if he could clarify what he meant, he replied, “No. Goodbye.”

No one at Drs ERgent Care or related companies, other than Elfenbein, has been charged or charged with a crime.

Elfenbein graduated from SUNY Upstate Medical University’s College of Medicine in New York in 2000. He ran unsuccessfully for the General Assembly in 2006 and 2010 and sought to fill a vacant seat in 2015.

Before the pandemic, First Call Medical Center had about 20 employees at a single site, according to an article for which Elfenbein was interviewed in the Upstate Medical University Alumni Journal. As of October, the company had about 200 employees at two urgent care centers, three coronavirus testing centers, two monoclonal antibody infusion centers and an upcoming mobile testing unit, according to the article.

“Covid-19 has impacted everyone,” Elfenbein told the newspaper. “We were able to be forward-thinking in providing needed public health services. In the process, it allowed us to grow as a company and create around 180 new jobs, which is a good thing.

After opening the first monoclonal antibody infusion site, according to the article, the company was approached by federal and Maryland health officials to operate a second monoclonal site and rapid testing center outside of Washington. FedEx Field, next to a state-run PCR testing facility. “In October, we were getting 15% of the state allocation for monoclonal antibodies,” Elfenbein told the newspaper.

In announcing Elfenbein’s indictment, the U.S. Attorney’s Office in Maryland said he was among 18 people across the United States, indicted in alleged fraud schemes that resulted in more than $149 million in bogus covid-related bills to federal programs and theft from assistance programs.

“It is unconscionable that this defendant sought to line his own pockets during a global pandemic by grossly overcharging Medicare and other insurers for these vital health care services during a national crisis,” the FBI special agent said. Thomas J. Sobocinski in a press release. “If the allegations against Dr Elfenbein and the other 17 people charged today are proven, they should be ashamed of their conduct and will be held accountable for their criminal acts.”

If convicted, Elfenbein would face a maximum of 10 years in federal prison on each of the three counts. The indictment says he was “aided and abetted by…others known and unknown to the Grand Jury,” but he did not name any.