Pandemic Pivot Under Scrutiny
The controversy traces back to 2020, when Elfenbein converted his medical clinics into COVID-19 testing hubs in Anne Arundel and Prince George’s counties. Prosecutors allege that behind the urgent public health response lurked a scheme: staff were instructed to bill the government for complex office visits even when patients spent just minutes at the clinics.
Those billing choices, known as “upcoding,” formed the backbone of the government’s fraud case. Elfenbein has countered that the medical codes were inherently ambiguous and allowed for differing, reasonable interpretations.
Conviction, Acquittal — and Back Again
After a three-week trial in 2023, a jury found Elfenbein guilty on all counts, exposing him to a potential 50-year prison sentence. But U.S. District Judge James K. Bredar later overturned the verdict, ruling that the government failed to show Elfenbein’s interpretation of the codes was unreasonable.
The Justice Department appealed, and in July, the Fourth Circuit called the matter “close” but concluded that Judge Bredar had gone too far. The appellate panel reinstated the possibility of conviction and agreed the government deserved another chance to prosecute.
