Convicted doctor objects to description of practice as ‘pill mill’

[TheLoneWolf]

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Didn't know Ruan was out. He and Couch will be retried.

Seems like solid cases are being lost or overturned against pain docs. IE the 5 pain guys in Michigan, one of which had an island.

How 4 doctors beat the feds in botched $500 million pill mill case

Four doctors convinced a jury that they were not running a pill mill in what the feds called one of the biggest health care scams in U.S. history.

www.freep.com

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[lobelsteve]

Google News

Comprehensive up-to-date news coverage, aggregated from sources all over the world by Google News.

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Didn't know Ruan was out. He and Couch will be retried.

Seems like solid cases are being lost or overturned against pain docs. IE the 5 pain guys in Michigan, one of which had an island.

How 4 doctors beat the feds in botched $500 million pill mill case

Four doctors convinced a jury that they were not running a pill mill in what the feds called one of the biggest health care scams in U.S. history.

www.freep.com

I believe Ruan and Couch were straight up dealers. Pills for shots taken to the extreme.

 

[TheLoneWolf]

I believe Ruan and Couch were straight up dealers. Pills for shots taken to the extreme.

They did an episode of American greed on them.

 

[hyperalgesia]

I believe Ruan and Couch were straight up dealers. Pills for shots taken to the extreme.

Did they believe they were saving the world? These docs always seem to have their heads in their a$$ and have zero self-awareness.

 

[lobelsteve]

Did they believe they were saving the world? These docs always seem to have their heads in their a$$ and have zero self-awareness.

Owning 10+ supercars makes me think Ruan knew exactly what he was doing. Raping and pillaging.

 

[paindoc007]

Two sides to anything. Feds can make anyone look like a drug dealing pills for shots scheming doctor. Anyone.

 

[lobelsteve]

Two sides to anything. Feds can make anyone look like a drug dealing pills for shots scheming doctor. Anyone.

You might want to see their PDMP....

 

[Ducttape]

these 2 guys were sleazy.

but the lawyers sure can put lipstick on them.



it seems pretty clear from the second article that the prosecutors sucked. not to comment what the doctors were guilty or not, but the entire thread talked about how Bothra was a legitimate interventional pain doctor.


yet the issue was not the interventions, it was the prescription opioids that were divvied out.

 

[Ducttape]

fwiw...

Specifically, the jury saw evidence that the defendants knowingly and willfully prescribed Schedule II and III Controlled Substances, including fentanyl, outside the usual course of professional practice and not for a legitimate medical purpose. The United States argued the defendants’ motive for this illegal prescribing was their own financial self-interest. The United States also argued that the defendants’ billing practices were systematically designed to unlawfully enrich the doctors.

Of particular importance in the trial were two brand name instant-release fentanyl drugs — Subsys and Abstral. Both Subsys and Abstral are only FDA-indicated for breakthrough cancer pain in opioid-tolerant adult patients. However, evidence showed that Dr. Ruan and Dr. Couch almost exclusively prescribed these drugs off-label for neck, back, and joint pain. The jury found that Dr. Ruan and Dr. Couch received illegal kickbacks from Insys Therapeutics, the manufacturer of Subsys, in exchange for the defendants prescribing massive quantities of this drug. Dr. Ruan and Dr. Couch were both among the top prescribers of Subsys in the entire United States. Evidence showed that Dr. Ruan began donating his Insys kickback payments the day after he received a copy of a criminal complaint from the Eastern District of Michigan against Dr. Gavin Awerbuch, another prolific Subsys prescriber who had been charged with receiving kickbacks from Insys. The United States argued that Dr. Ruan’s decision to donate his Insys money was done in an attempt to distance himself from the company.

With regard to Abstral, evidence showed that Dr. Ruan and Dr. Couch purchased approximately $1.6 million worth of stock in Galena Biopharma, the manufacturer of Abstral, and sought to manipulate the stock price by driving up Abstral sales. From the third quarter of 2013 through the 2014, Dr. Ruan and Dr. Couch were the number one and two prescribers of Abstral in the entire United States. During this same time period, nearly one out of every three Abstral prescriptions written in the U.S. were written by either Dr. Ruan or Dr. Couch.

As part of their criminal enterprise, Dr. Ruan and Dr. Couch owned C&R Pharmacy, which was co-located with one of the PPSA clinic locations. C&R Pharmacy would only fill prescriptions written by the doctors at PPSA, and Dr. Ruan and Dr. Couch split 75% of the profits that came in from the prescription drug reimbursements. Approximately 91% of the Subsys and Abstral prescriptions written by the defendants — which cost patients’ insurance anywhere between $1,000.00 to $24,000.00 per month — were filled at C&R Pharmacy.

In addition to C&R Pharmacy, the defendants also had a worker’s compensation dispensary, from which they directly dispensed Controlled Substances. The jury heard evidence that Dr. Ruan and Dr. Couch received guaranteed monthly kickbacks from a dispensary management company — Industrial Pharmaceuticals Management (“IPM”) and later Comprehensive Rx (“CRX”) — in exchange for the defendants dispensing certain drugs with high reimbursement rates. These monthly guaranteed amounts reached $80,000.00 per month for Dr. Ruan and $20,000.00 per month for Dr. Couch. The millions paid in kickbacks to the defendants associated with the worker’s compensation dispensary went into private bank accounts set up by the defendants.

While there were some patients who received legitimate medical care at PPSA, the jury heard evidence that many patients rarely saw either of the doctors, and that the nurse practitioners who treated Dr. Couch’s patients were abusing drugs at the work place and then seeing patients. In addition, the jury heard evidence that Dr. Couch knowingly permitted one of his nurse practitioners, Justin Palmer, to forge Dr. Couch’s name on prescriptions for Controlled Substances. Palmer testified that he forged Dr. Couch’s name approximately 25,000 times while working at PPSA.

 

[TheLoneWolf]

Two sides to anything. Feds can make anyone look like a drug dealing pills for shots scheming doctor. Anyone.

Not really. You can run a no narcotic practice and not have to worry about these matters.

 

[Agast]

In the article he says it couldn’t possibly be a pill mill due to the number of staff employed to maintain operations. So he’s got a bunch of oompa loompas running a candy factory lol

 

[Laryngospasm]

They did an episode of American greed on them.

Where can we find it? I saw the one on the mobile guys.. would like to watch this one

 

[Ducttape]

Season 12, Episode 2.

 

[jwalker12]

I often see patient's in my practice on opioids for "failed back syndrome". With stims in place not working just on opioids. What are you guys offering for these patients besides the neuropathics/PT/Chiro that never seems to work? What about the 75year old active gardening lady who just wants to continue her activites with less pain?

 

[lobelsteve]

I often see patient's in my practice on opioids for "failed back syndrome". With stims in place not working just on opioids. What are you guys offering for these patients besides the neuropathics/PT/Chiro that never seems to work? What about the 75year old active gardening lady who just wants to continue her activites with less pain?

More stim

 

[Ferrismonk]

I often see patient's in my practice on opioids for "failed back syndrome". With stims in place not working just on opioids. What are you guys offering for these patients besides the neuropathics/PT/Chiro that never seems to work? What about the 75year old active gardening lady who just wants to continue her activites with less pain?

First, you need to ascertain their motivation for getting better. In my experience, most are tired and just want more drugs to numb the pain. They're often not interested in more procedures, surgeries, or non-medicine treatments.

If they're motivated circle back. Okay to try ESI. Possibly newer stim with newer technology. Lifestyle changes such as no smoking, better diet, low-impact exercise. Pain psych with CBT and coping.

That being said, it's called "failed back" for a reason. You can only do what you can do.

 

[MitchLevi]

Those old ladies need an RFA