Alexandria physician pleads guilty to workers’ comp fraud conspiracy

(Source: MGN)
Published: Mar. 31, 2022 at 5:52 PM CDT
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The following was released by the United States Department of Justice:

FAYETTEVILLE, Ar. - An Alexandria physician pleaded guilty on March 29, 2022, 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 Smith60, waived indictment by a grand jury and pleaded guilty to criminal information charging him with conspiracy to commit health care fraud, wire fraud, and illegal remunerations (taking kickbacks).

Court documents allege that the basic premise of the scheme, which ran from 2013 until 2017, was that individuals associated with a Rogers-based medical supply and billing company recruited Smith to dispense pain creams and patches to his workers’ compensation patients by offering him a split of the profits. The Rogers company acted as the billing agent for Smith, handling all the paperwork and submitting the allegedly fraudulent claims to both the U.S. Department of Labor, the Office of Workers’ Compensation Programs, which covers all federal employees, and to private insurers as well. In exchange, Smith admitted, the company paid him 50 to 55 percent of the profits collected from successfully billing insurers, at markups of 15 to 20 times what the medications actually cost.

According to court documents, Smith, a Louisiana physician, made more than $650,000 from the scheme. Smith admitted that in addition to receiving illegal kickbacks, he knew he did not have a license to dispense medications from his clinic, required under Louisiana law, and nonetheless bought topical medications from the Rogers company and dispensed them to his workers’ compensation patients from his clinic.

Smith is the second physician to plead guilty in connection with the federal investigation. In July 2021, Dr. Robert Dale Bernauer Sr., another Louisiana doctor, pleaded guilty to conspiring with the same individuals, in a scheme similar to the one for which Smith has accepted responsibility. Additionally, in October 2021, the company’s former billing director, Amanda Dawn Rains, pleaded guilty to participating in criminal conspiracies with the two doctors, and others.

As a result of his guilty plea, Smith may be sentenced to up to five years in prison. The court will determine his sentence at a later date, after reviewing a pre-sentence investigation report prepared by the U.S. Probation Office and considering the U.S. Sentencing Guidelines and other statutory factors.

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