Robert Clay Smith, 60, of Alexandria, Louisiana, is the second doctor to plead guilty to accepting illegal kickbacks from a medical supply and billing company located in Rogers, Arkansas. Dr. Robert Dale Bernauer, Sr. of Louisiana pleaded guilty to his part in the scheme in July 2021. Also, a former billing director for the Rogers-based company, Amanda Dawn Rains, pleaded guilty in October 2021. (Where there’s one fraudster, there’s usually more.)
Smith was allegedly recruited by the medical supply and billing company to dispense pain creams and patches to his patients who were receiving workers’ compensation benefits. (He got a split of the profits to do so. The official term is “kickback.”)
The Rogers-based company took care of all the paperwork by submitting the fraudulent claims to the U.S. Department of Labor, Office of Workers’ Compensation Programs, which covers federal employees. Smith was paid up to 55 percent of the profits collected from billing insurers for medications that had been marked up by 15 to 20 times more than the actual cost.
Smith was paid more than $650,000 for participating in the kickback scheme between 2013 and 2017. Interestingly enough, he did not have a license to dispense medications at his clinic. Despite this very important fact, Smith bought the topical medications from the company and dispensed them to his workers’ compensation patients anyway.
Smith pleaded guilty to conspiracy to commit healthcare and wire fraud for the unlicensed administering of pain creams and patches to his workers compensation patients and billing insurers at a significant markup. When sentenced, he faces up to five years in prison. (What if the judge were to mark up his sentence 15 to 20 times?)
Today’s Fraud of the Day comes from the Department of Justice press release, “Second Doctor Pleads Guilty to Workers’ Comp Fraud Conspiracy,” dated March 29, 2022.
FAYETTEVILLE – An Alexandria, La., physician pleaded guilty today to having conspired to violate three different federal statutes in connection with a scheme to defraud both federal and private workers’ compensation insurers.
U.S. District Judge Timothy L. Brooks presided over the plea hearing, in which Robert Clay Smith, 60, waived indictment by a grand jury and pleaded guilty to a criminal information charging him with conspiracy to commit health care fraud, wire fraud, and illegal remunerations (taking kickbacks).