Five months after being indicted in an alleged conspiracy to distribute pain medication, two Mobile physicians have been hit with 17 new charges that include allegations of money laundering, mail fraud, racketeering and kickbacks from pharmaceutical distributors.

Dr. John Patrick Couch and Dr. Xiulu Ruan were originally indicted in May, but the new charges were brought after the owner of a pharmaceutical supply company admitted to providing financial kickbacks to both doctors last month.

Christofer Manfuso pleaded guilty in October to anti-kickback violations in a plea deal with federal prosecutors. Manfuso owns Comprehensive RX Management and in the plea deal he acknowledged paying $864,770 to Couch and $1.7 million to Ruan over a three-year period.

That alleged scheme is the basis for a new superseding indictment, which includes allegations of the kickbacks as well as the money laundering and wire fraud charges investigators say was necessary to maintain them.

The allegations in the indictment say taxpayers were on the hook for some of the worker’s compensation claims involved in the conspiracy that were insured through federal health care programs.

Other co-conspirators are mentioned in the new indictment and on Wednesday, Nov. 4, they were identified as Thomas Justin Palmer and Bridgette Williams Parker, staff members at Physicians Pain Specialists of Alabama (PPSA), which the doctors owned together.

According to court documents, one co-conspirator is accused of forging Couch’s signature on prescriptions for pain medication to increase the number of patients the doctors were able to supply.

The reimbursements for this “upcoding” of services resulted in PPSA being paid approximately “30 percent more per doctor visit by” health insurance providers they the business was entitled to.

The indictment also claims co-conspirators conducted unnecessary drug screenings to make the distribution of the controlled substances appear to be “proper” and “legitimate.” Those screenings were sent off for additional testing at the expense of patients health insurance providers — namely Blue Cross and Blue Shield of Alabama, among others.

The indictment also alleges many patients received their prescriptions before their urine was even sent off for testing. The communication with BCBS seems be the basis for some of the additional fraud charges.

“The submission of bills to healthcare providers and the payment from the healthcare providers caused interstate wire transmissions, to include emails, and electronic wire transfers, to be sent to and from the state of Alabama,” the indictment reads.

Pain pills distributed to worker’s compensation patients were also allegedly sent through FedEx and other carriers to the PPSA office located at 2001 Springhill Avenue in Mobile.

Manfuso is scheduled to be sentenced for his role in the conspiracy in April of 2016, and he is expected to testify against Ruan and Couch during an upcoming trial scheduled in January of 2016.

The new allegations have added to the potential sentence of both doctors, and if convicted, multiple charges carry the potential for fines of up to $250,000 and up to 20 years in prison.

Accompanying the superseding indictment was a listed forfeiture notice seeking the Alabama Medical Licenses of both physicians, as well as financial accounts related to their personal banking, investment and business activities.

The two are scheduled to be arraigned on the new charges a 2 p.m. on Thursday.

Updated on Nov. 4 to include the names of co-conspirators Thomas Justin Palmer and Bridgette Williams Parker.