United States Attorney Kenyen R. Brown of the Southern District of Alabama, along with FBI-Mobile Special Agent in Charge Robert Lasky, and DEA-Mobile Special Agent in Charge Keith Brown from the New Orleans Field Division announced the arrests of Dr. John Patrick Couch and Dr. Xiulu Ruan on Wednesday morning.
Couch and Ruan are physicians licensed to practice medicine in the State of Alabama. The doctors jointly own and operate Physician’s Pain Specialists of Alabama (PPSA), which has two clinic locations in Mobile — one located at 2001 Springhill Avenue and the other at 4682 Airport Boulevard. Couch and Ruan also co-own C&R Pharmacy, which is located adjacent to the PPSA location on Airport Boulevard.
In April 2015, a grand jury in the Southern District of Alabama returned an indictment charging Couch and Ruan with conspiracy to distribute controlled substances outside the usual course of professional practice and not for a legitimate medical purpose, and conspiracy to commit healthcare fraud.
According to the indictment, Couch and Ruan conspired with each other and others to knowingly and willfully distribute and dispense Schedule II controlled substances outside the usual course of professional practice and not for a legitimate medical purpose. The Indictment identifies some of these Schedule II drugs as: oxycodone (brand name: Oxycontin), oxycodone hydrochloride (brand name: Roxicodone), oxymorphone (brand name: Opana), hydromorphone (brand name: Dilaudid), morphine, fentanyl, and methadone.
The Indictment also alleges Couch and Ruan engaged in a conspiracy to commit healthcare fraud to increase the health insurance reimbursements received by PPSA. Two means of healthcare fraud are identified in the Indictment. First, the Indictment alleges the doctors routinely ordered extremely expensive secondary urine drug tests, which were billed to patients’ insurance providers under the false pretense that they were necessary tests.
However, the Indictment alleges these tests were ordered primarily because of the extremely high rate of reimbursement paid by insurance providers for these tests. Furthermore, the Indictment alleges Couch and Ruan engaged a conspiracy to fraudulent up-code, which is where a patient service performed by a physician extender, such as a nurse, is fraudulently billed under the physician’s national provider identifier number. Fraudulent up-coding results in a medical practice receiving more money than it was entitled to, because health insurance providers reimburse patient services at a higher rate when performed by a physician.
In addition to the criminal allegations, the Indictment contains forfeiture notices stating that the United States intends to seek the forfeiture of numerous bank accounts, exotic vehicles, and real property if the defendants are convicted of one or both of these conspiracy offenses.
Along with the arrests of the two doctors and the seizures of assets subject to forfeiture, the FBI and DEA jointly executed search and seizure warrants at five locations, including both PPSA clinics, C&R Pharmacy, a warehouse where Ruan stored his exotic cars, and Couch’s house.
“We will remain vigilant in prosecuting doctors who place greed over their Hippocratic Oath to help their patients and are otherwise willing to defraud and undermine the health care programs of the nation,” said United States Attorney Kenyen R. Brown.
“This national organized crime enterprise fleeced the health care system through a wide range of money making criminal fraud schemes,” said FBI SAC Robert F. Lasky. “The FBI, working in conjunction with our federal agency partners, is resolute in its commitment to stop those who would illegally manipulate the health care system.”
“Prescription drug abuse is the fasting growing drug problem in the country. It is particularly troubling to find doctors so complicit in this epidemic. We trust our doctors to heal our bodies, not poison our communities. We will not tolerate or accept this illegal behavior, and we will bring justice to those that condone this type of practice,” said DEA Assistant Special Agent in Charge Clay A. Morris.
As in all criminal cases, an Indictment is only an allegation made by a grand jury. Both Dr. Couch and Dr. Ruan are presumed innocent until proven guilty.
This matter was jointly investigated by FBI-Mobile and DEA-Mobile, and the case will be prosecuted by the U.S. Attorney’s Office for the Southern District of Alabama.