Mobile doctors in painkiller case plead not guilty - allegedly ran pill mill in $40 million operatio
Mobile, AL
John Patrick Couch and Xiulu Ruan allegedly ran a pill mill, took kickbacks to prescribe painkillers, and made up to $40 million running the operation, court records show.
On Wednesday, the two Mobile doctors pleaded not guilty to 19 criminal counts in the U.S. District Court of Mobile.
"What they're trying to do is punish Dr. Couch and they're trying to punish Dr. Ruan for running a very successful practice that had a lot of people depending on them to get their pain medication," said John Beck, Couch's attorney, after the hearing.
Nurse practitioners Thomas Justin Palmer and Bridgette Williams Parker were also charged with conspiracy to distribute controlled substances in the superseding indictment. They pleaded not guilty as well.
All four people worked at Physician's Pain Specialists of Alabama, a business jointly owned by Couch and Ruan.
According to the indictment, people from states such as Tennessee and Kentucky traveled to the South Alabama practice to obtain narcotics such as oxycodone, fentanyl, hydrocodone, and morphine.
The two doctors wrote 277,982 prescriptions for controlled substances between Jan. 1, 2011 and May 20, 2015, according to the indictment.
The superseding indictment includes counts of RICO conspiracy, drug conspiracy, health care fraud conspiracy, money laundering conspiracy, conspiracy to violate anti-kickback statute, wire and mail fraud conspiracy, four counts of distribution of a controlled substance, three counts of money laundering, and six counts of anti-kickback violations.
Dennis Knizley, an attorney representing Ruan, disputed the new counts. He said that that no one has dispensed anything inappropriately under their supervision of Couch and Ruan.
"These are successful, honest doctors that made money and people may resent it, but we hope not," Knizley said.
According to the superseding indictment, Couch and Ruan increased their profits by persuading medical firms Industrial Pharmacy Management and Comprehensive RX Management to pay them kickbacks in return prescribing drugs provided by the two firms. The two firms supplied drugs to the doctors' 250 workers compensation patients.
In exchange, Industrial Pharmaceuticals Management agreed to pay Couch a kickback of $18,000 per month and Ruan $45,000 per month, court records show.
Ruan would email the owner of the firms, Christopher Manfuso, and verify through emails what drugs to give people in order to get the most money, the superseding indictment states. Manfuso entered a guilty plea in the case last month and has agreed to cooperate with prosecutors.
As part of a nationwide crackdown on pain pill abuse, Couch and Ruan were charged six months ago with one count each of conspiracy to distribute controlled substances and conspiracy to commit health care fraud.
According to the original indictment, they allegedly ordered expensive urine tests under the false pretense that they were necessary. The tests were billed to the patients' insurance companies because the insurers would pay a high reimbursement rate.
The doctors also participated in a scheme where a service performed by someone other than a doctor was billed under the doctor's national provider identifier number, according to the original indictment. That way, the insurance companies would see that a doctor performed the service and reimburse them at a higher rate.