US lawyer: former executive pleads guilty to playing a role in workers’ tax evasion

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A former executive at a Rogers medical supplies and billing company pleaded guilty today to one count of conspiracy to commit mail fraud, wire fraud, healthcare fraud, fraud to obtain compensation from federal employees and illegal remuneration (payment of bribes), in connection with a scheme to defraud the US government and private insurance companies by overcharging unnecessary drugs supplied to patients of work accident.

U.S. District Judge Timothy L. Brooks presided over the plea hearing, in which Amanda Dawn Rains, 39, waived grand jury charge and pleaded guilty to a criminal investigation accusing her of conspiracy to violate five different federal laws. According to court documents, Rains, who in 2013 was hired as the billing manager of an unidentified Rogers company, was involved in a fraud scheme that spanned from 2011 to 2017 and defrauded compensation insurers federal and private workplace accidents.

Court documents allege that the basic premise of the program was that individuals associated with the Rogers company recruited doctors to distribute pain creams and patches to their patients by offering them workers compensation by offering them a share of profits collected from successfully billing insurers, typically 50 percent. One of those doctors was Robert Dale Bernauer, Sr., who ran a clinic in Lake Charles, La. Bernauer pleaded guilty to his role in the same plot on July 30, 2021.

After signing contracts with doctors, the company supplied them with pain creams and patches, and acted as a billing agent for the doctors, handling all paperwork and submitting claims allegedly fraudulent at the US Department of Labor, the Workers’ Compensation Bureau. Programs, which cover all federal employees, as well as private insurers. The company billed insurers 15 to 20 times the actual cost of the drugs, then paid the doctors kickbacks on the amounts collected.

According to court documents, Rains’ role in the conspiracy included: managing the Rogers company billing system and electronically submitting alleged fraudulent claims to the Department of Labor and private insurers; maintaining a “do not exempt” list of insurers who have refused to pay the company’s claims; advise doctors and clinics on how to respond to insurance companies that question the charges; ship company medications to doctors and clinics; prepare presentations used by company sales representatives to recruit doctors who falsely claimed the trade deal did not violate anti-kickback laws; and continue to ship drugs to Bernauer and bill insurers for his prescriptions knowing that he did not have the Louisiana license required to dispense drugs.

In his plea deal, Rains promises to pay restitution to the Ministry of Labor and other insurers who are victims of the conspiracy, in amounts to be determined. The indictment document for his case alleges the total losses include more than $ 3.9 million paid by the Ministry of Labor and amounts paid by private insurers that have yet to be calculated, but include nearly $ 2 million payments related to medicines dispensed by Bernauer alone.

According to court documents in the related case, Bernauer has already paid $ 664,176.30 in restitution to the Ministry of Labor and $ 361,096.70 to the court registry, to go to other victims of the fraud, for a total of of $ 1,025,273 in compensation paid to date.

Following her guilty plea to the single count of conspiracy, Rains can be sentenced to up to five years in prison. The court will determine his sentence at a later date, after considering a pre-sentence investigative report prepared by the US Probation Office and taking into account US sentencing guidelines and other statutory factors.

Acting US attorney David Clay Fowlkes of the Western District of Arkansas made the announcement.

The case was investigated by the Ministry of Defense, the Defense Criminal Investigation Service, the Office of the Inspector General of the Ministry of Labor, the Office of the Inspector General of the Ministry of Veterans Affairs, the Office of the Inspector General of the United States Postal Services, with assistance from the Internal Revenue. Service-Criminal Investigation, Louisiana Department of Justice, Louisiana State Board of Forensic Pathologists, and Louisiana Board of Pharmacy.

Deputy US prosecutors Steven Mohlhenrich and Hunter Bridges continued the case for the United States.

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