A former employee of doctors John Couch and Xiulu Ruan, who was implicated in an indictment alleging a conspiracy to distribute vast amounts of powerful and addictive prescription painkillers, pleaded guilty today for her alleged role in the scheme. Bridgette Williams Parker, a former nurse at Physicians Pain Specialists of Alabama (PPSA) — which was owned by Couch and Ruan — admitted that she “knowingly and willingly conspired” with the doctors to prescribe and dispense “controlled substances outside the usual course of professional practice or not for a legitimate medical purpose.”

The indictment alleged PPSA essentially operated as a “pill mill,” where patients did not receive medically acceptable scrutiny beyond intake, while the doctors allowed nurses to forge prescriptions for large amounts of oxycodone, morphine, hydrocodone and fentanyl, while they also accepted kickbacks from a pharmacist and ordered unnecessary testing and “upcoding” to increase profits.

The doctors were arrested as part of the nationwide, multi-agency “Operation Pillution” in May, and Parker’s plea represents the second in the case along with Christopher Manfuso, a pharmacist who admitted in October to paying the doctors more than $2.5 million in kickbacks over a three year period. Prosecutors have alleged the doctors became personally enriched as a result of the scheme, and have sought to seize property, bank accounts and exotic cars as the case has progressed.

Parker’s agreement acknowledges sentencing guidelines recommending as many as 20 years in prison and fines reaching as much as $250,000, but notes the defendant has an opportunity — but no obligation — to cooperate with prosecutors on further investigation of the case.

Couch and Ruan have pleaded not guilty to the indictment, and their trial is tentatively scheduled for March 2016.