COVID Scheme Doctor Suit Returns to Trial After Supreme Court Declines Review

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Supreme Court Says No

Elfenbein took his fight to the nation’s highest court in early November, urging the justices to decide whether healthcare providers can face criminal liability when they rely on what they view as reasonable readings of murky billing rules.

“The petition concerns the government’s burden to prove the element of falsity,” Elfenbein argued, especially in cases hinging on ambiguous regulations.

The Supreme Court declined without comment, a silence that spoke volumes for prosecutors — and disappointment for defense attorneys watching the False Claims Act landscape.

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Legal Ripples Beyond One Doctor

The Fourth Circuit’s ruling has sparked debate among healthcare lawyers over whether coding ambiguity should block fraud prosecutions altogether. Elfenbein argued his case offered the perfect vehicle for the Supreme Court to clarify that line.

Jonathan Porter, a partner at Husch Blackwell LLP and a former federal prosecutor not involved in the case, said the outcome was hardly shocking.

“The issues in the Elfenbein case are somewhat unusual,” Porter told Law360. “It’s not surprising the Supreme Court opted against hearing it.”