Case Document 43 Filed 04/30/15 OPE A Noon/ST A IN THE UNITED STATES DISTRICT COURT CHARL 4? 3 02075 FOR THE SOUTHERN DISTRICT OF ALABAMA ?58 a D, SOUTHERN DIVISION 4591:), JR UNITED STATES OF AMERICA Criminal NO. IS-QOO C6 v. USAO NO.: 13R00521 JOHN PATRICK COUCH, M.D., VIOLATIONS XIULU RUAN, M.D., 21 U.S.C. 846 18 U.S.C. a 1349 Forfeiture Notice INDICTMENT THE GRAND JURY CHARGES: INTRODUCTION 1. A Defendant JOHN PATRICK COUCH, MD. is a physician licensed to practice medicine in the State of Alabama. 2. Defendant XIULU RUAN, MD. is a physician licensed to practice medicine in the State Of Alabama. 3. Together, RUAN co-own a medical practice named Physician?s Pain Specialists of Alabama PPSA has two clinic locations in Mobile, Alabama one at 2001 Springhill Avenue, and the other located at 4682 Airport Boulevard. 4. COUCH and RUAN also co?own a pharmacy named Pharmacy, which is located adjacent to the PPSA clinic on Airport Boulevard in Mobile, Alabama. 5. COUCH and RUAN both employ physician?s extenders, such as physician?s assistants certi?ed registered nurse practitioners and certi?ed registered nurse anesthetists at PPSA. COUNT ONE (CONSPIRACY TO DISTRIBUTE CONTROLLED SUBSTANCES) 21 U.S.C. 846 6. The GrandiJury incorporates number paragraphs 1?5 Of this Indictment as if fully Case 1:15?mc?01004 Document 4?3 Filed 04/30/15 Page 4 of 14 set forth herein. 7. Beginning in or about January 2011, and continuing through the date of this Indictment, in the southern District of Alabama, Southern Division, and elsewhere, the defendants, JOHN PATRICK COUCH, M.D., and XIULU RUAN, M.D., conspired with each other and with others, both known and unknown to the Grand Jury, to knowingly, willfully, and unlawfully distribute and dispense, and cause to be distributed and dispensed, Schedule controlled substances, including, but not limited to; Oxycodone (brand name: Oxycontin), Oxycodone Hydrochloride (brand name: Roxicodone), Oxymorphone (brand name: Opana), Hydromorphone (brand name: Dilaudid), Morphine, Fentanyl, and Methadone, outside the usual course of professional practice and not for a legitimate medical purpose, in violation of Title 21, United States Code, Section 84l(a)(1). All In violation of Title 21, United States Code, Section 846. . COUNT TWO (CONSPIRACY TO COMMIT FRAUD) 18 U.S.C. 1349 8. I The Grand Jury incorporates number paragraphs 1?-5 of this Indictment as if fully set forth herein. 9. Beginningin or about January 2011, and continuing through the date of this Indictment, in the Southern District of Alabama, Southern Division, and elsewhere, the defendants, OHN PATRICK COUCH, M.D., and XIULU RUAN, M.D., did knowingly, willfully, and unlawfully combine, conspire, confederate, and agree with each other and others, both known and unknown to the Grand Jury, to knowingly and willfully execute, and attempt to execute a scheme and arti?ce to de?aud healthcare benefits pro grams, and'to Case Document 4?3 Filed 04/30/15 Page 5 of 14 obtain, by means of false and fraudulent pretenses, representations, and promises, money and property owned by, and under the custody and control of, healthcare bene?ts programs in connection with the delivery of and payment for healthcare bene?ts, items, and services, in violation of Title 18,.United States Code, Section l347(a). Obiective of the Conspiracy 10. The objective of the conspiracy was to unlawfully increase the amount of reimbursement PPSA, and thus OHN TATRICK COUCH, MD. and XIULU RUAN, M.D., received from healthcare bene?ts pro grams. Manner and Means 11. The manner and means used to achieve this objective included, but werere not limited to, the following: A. During patient visits at PPSA, patients provide a urine sample for a? .point?of?care urine screen The alleged purpose of the UDS was to determine whether a patient was taking the medications prescribed to them and to ensure that the patient was not taking medication not prescribed to them. However, after running the in?house UDS, patients? urine samples were sent to outside laboratories for a much more expensive. gas chromatography-mass spectrometer analysis. . The analyses were billed to providers under the false pretense that they were necessary tests. However, the analyses were ordered primarily because of the extremely high rate of reimbursement paid by insurance providers for these tests. Thus, COUCH and RUAN ordered thousands of analyses under false pretenses to increase pro?ts. . B. Patient services performed by PP SA physician extenders were fraudulently billed to patients? insurance providers under the unique National. Provider Identi?er number assigned to JOHN PATRICK COUCH, M.D. Insurance providers reimburse at Case 1:15?mc?01004 Document 4-3' Filed 04/30/15 Page 6 of .14 a higher rate, for patient services performed by a physician, compared to services performed by a physician extender. Thus, by submitting bills for reimbursement under NPI when the patient service had been performed by a physician extender, insurance providers were fraudulently induced to reimburse PPSA at a higher rate. All in violation of Title 18, United States Code, Section 1349. FORFEITURE NOTICE Pursuant to Rule 32.2ta), Ped. Crim. P., the allegations contained in Counts One and Two of this Indictment are hereby repeated, re?alleged, and. incorporated by reference herein as though fully set forth at length for the purpose of alleging forfeiture pursuant to Title 21, United States Code, Section 853', Title 18, United States Code, Section and Title 28, United States Code, Section 2461. If JOHN PATRICK COUCH, MD. and XIULU RUAN, MD. are convicted of Count One? or Two of this Indictment, they are jointly and severally liable for the amounts subject to forfeiture. T0 DISTRIBUTE AND DISPENSE The allegations contained in Count One of this Indictment are hereby re?alleged and incorporated by reference for the purpose of alleging forfeiture pursuant to Title 21, United States Code, Section 853; I Upon conviction of an offense as set' forth in Cotmt One of this Indictment, the defendants JOHN PATRICK COUCH, MD. and XIULU RUAN, M.D., shall forfeit to the United States of . America, pursuant to Title 21, United States Code, Section 853, any property, real or personal, vvhich constitutes or is derived from any proceeds the defendants COUCH and RUAN, obtained, directly or indirectly, as the result of such violation(s), and any property used, or intended to be used, in any manner or part, to commit, or to facilitate the commission of, such violation(s). The property to be forfeited includes, but is not limited to, the following: Case 1:15?mc?01004 Document 4?3 Filed 04/30/15 Page 7 of 14 1. The contents of the following accounts associated with PP SA and Pharmacy: A. Wells Fargo account ending in X6971, in the name of Physician?s Pain Specialist of Alabama B. Wells Fargo account ending in X1719, in the name of C. Wells Fargo account ending in X7 003, in the name of C8511 Pharmwy, L.L.C. - 2. The contents of the following accounts associated with XIULU RUAN, M.D.: A. State Bank Trust account ending in X5553, in the name of XLR Exotic Autos, B. State Bank Trust account ending in x5264, in the name of Ruan Companies, . C. State Bank Trust account ending in x6197 in the name of Xiulu Ruan; D. Wells Fargo account ending in x1921, in the name of XLR Properties, E. Wells Fargo account ending in X1212, in the name of Physicians . Weight Loss and Wellness, - F. Community Bank account ending in X9013, in the name of "Xiqu Ruan; G. Capital One Sharebuilder Investment Account ending in x6197~01 in the name of Xiulu Ruan', H. Voya Financial 401K account plan ending in x7645 inthe name of Xiqu Ruan; . 1. College Counts 529 Fund, account ending in x3712, owned by Xiulu Ruan; 1. College Counts 529 Fund, account ending in X3713, owned by Xiulu Ruan; 3. The contents of the following accounts associated With JOHN PATRICK COUCH, M.D.: A. \/Wells Fargo account ending in X0015, in the name of John Patrick Couch; Wells Fargo account ending in X6997, in the name of Physician?s Compounding Solutions, Wells Fargo Account ending in X9 824, in the name of John Patrick . Couch V113. Wells Fargo account ending in x6989, in the name of Properties, l/E Trustmark account ending in X0135, in the name of John Patrick Case 1:15?mc?01004 Document 4?3 Filed 04/30/15 Page 8 of 14 Couch, E?Trade Investment account ending in X4755, in the name of LP. Couch; E~Trade Investment account ending X8497, inthe name of John P. Couch; E-Trade Investment account ending in X83 63, in the name of IF. Couch; Voya Financial 401K account plan ending in X7645, in the name of John Couch; . . J. Allianz Annuity account ending in X6369, in the name of John P. . ouch; an 5389, mt?c name of P. . WW account en in Couch; . . College Counts 529 Fund, account ending in X2423 owned by John P. Couch; M. 7g College Counts 529 Fund, account ending in owned by John P. Conch; N. ,4 College Counts 529 Fund, account ending in owned by John P. Couch. 4. 1 The following vehicles associated with XIULU RUAN, M.D.: A. I Aston Martin DB9 Volante, VIN Audi R8 Spyder VIN 2007 Bentley Continental GT, VIN 1987 BMW M6, VIN Ferrari F430 Convertible, VIN Ferrari 599 GTB, VIN 1994 Lamborghini Diablo, VIN 2008 Lamborghini, VIN 2005 Mercedes SLR, VIN 2011 Mercedes Model SLS AMG, VIN 2013 Mercedes SLS AMG GT, VIN Shelby Series 1, VIN Spyker C9 Laviolette 1G69ZB 63202; cnn?mcewcow 5. The following vehicles associated with JOHN PATRICK COUCH, M.D.: A. 2008 Cadillac Escalade, VIN B. 2010 Land Rover, VIN c. 2013 Maserati, VIN 2015 Porsche 911, VIN 6. The following real property associated with XIULU M.D.: Case 1:15?mc?01004 Document 4?3 Filed 04/30/15 Page 9 of 14 e11 Ct. Mobile, Alabama; A. 2800 Churchb ad, Mobile, Alabama; B. 1301 Leroy Stevens R0 ated with JOHN PAT RICK COUCH, M.D.: 7. The following real property associ 3 19 Woodbridge Drive Daphne, Alabama; erdido Beach Orange Perdido Beach Orange MD. and XIULU each, Alabama; . A. Beach, Alabama. B. Unit 25040 C. Unit 28105 ATRICK COUCH, 8. A money judgment against JOHN RUAN MD. re resentin a sum of mone equal to the proceeds the defendants obtained, directly or indirectly, as a result of a violation of Title 21, 846. tto 21U.S.C. 853 and 28 use. 2461(0). All pursuan CONSPIRACY TO COMMIT HEALTH CARE FRAUD FOBFEITURE ctment are hereby rte-alleged and The allegations contained in Count Two of this lndi ence for the purpose of allegingforfeiture. fTitle 18, United-States Code, Section 982(a)(7) and Title 28, incorporated by refer Pursuant to the provisions 0 Section 2461 if convicted the offense set forth in Count Two, defendants United States Code JOHN PATRICK COUCH, MD. and XIULU RUAN, MD. shall forfeit property, real or personal, that cons 'tutes or is derived, directly or indirectly, from gross proceeds traceable to the commission of the offense. The property to be forfeited in ludes, but is not limited to, the following: 1. The contents of the following accounts associated with PP SA and Pharmacy: A. Wells Fargo account ending in ?6971, in the name of Physician?s Pain Specialist of Alabama B. Wells?Fargo account ending in X1719, in the name of C. Wells Fargo account ending in x7003, in the name of Pharmacy, L.L.C. 2. The contents of the following accounts associated with XIULU RUAN, M.D.: A. State Bank 82; Trust account ending in x5553, in the name of XLR Exotic Autos, B. State Bank 85 Trust account ending in 2:57.64, in the name of Ruan - 7 Case Document 4?3 Filed 04/30/15 Page 10 of 14 Companies, C. State Bank Trust account ending in X6197 in the name of Xiulu Ruan; D. Wells Fargo, account ending in' X1921, in the name of XLR Properties, E. Wells Fargo account ending in X1212, in the name of Physicians Weight Loss and Wellness, F. Community Bank account ending in X9013, in the name of Xiulu Ruan; G. Capital One Sharebuilder Investment Account ending in in the name of Xiulu Ruan; Xiulu Ruan; 1. College Counts 529 Fund, account ending in x3712, owned by Xiqu Ruan; I J. College Counts 529 Fund, account ending in X3713, owned by Xiqu Ruan; 3. The contents of the following accounts associated with JOHN PATRICK COUCH, M.D.: A. Wells Fargo account ending in X0015, in the name of John Patrick Couch; B. ?Wells Fargo account ending in X6997, in the name of Physician?s Compounding Solutions, C. Wells Fargo Account ending in X9824, in the nameof John Patrick Couch D. Wells Fargo account ending in X6989, in the name of JPC Properties, E. Trustmark account ending in X0135, .in the name of John Patrick Couch, . F. E?Trade Investment account ending in X4755, in the name of .P. Couch; i G. E~Trade Investment account ending in X8 497, in the name of John P. Couch; H. E?Trade Invostment account ending in X83 63, in the name of .P. Couch; - I. Voya Financial 401K account plan ending in X7645, in the name of John Couch; . J. Allianz Annuity account ending in X63 69, in the name of John P. Couch; K. Allianz Annuity account ending in X5389, in the name of John P. Couch; Case Document 4?3 Filed 04/30/15 Page 11 of 14 L. College Counts 529 Fund, account ending in x2423, owned by John P. Couch; M. College Counts 529 Fund, account ending in owned by John P. Couch; N. College Counts 529 Fund, account ending in x2406; owned by John P. Couch. - 4: The following vehic es associated with XIULU RUAN, M.D.: Aston Martin DB9 Volante, VIN Audi as Spyder er D. 1987 BMW M6, VIN 60721; Ferrari F430 Convertible, VIN F. Ferrari 599 GTB, VIN . G. 1994 Lamborghini Diablo, VIN 2008 Lamborghini, VIN I 2005 Mercedes SLR, VIN 2011 Mercedes Model SLS AMG, VIN 2013 Mercedes SLS AMG GT, VIN - L. Shelby Series 1, VIN M. Spyker C9 Laviolette 1G69Z3 63202; 5. The following Vehicles associated with JOHN PATRICK COUCH, M.D.: A. 2008 Cadillac Escalade,VIN B. 2010 Land Rover, VIN o. 2013 Maserat1,VlN D. 7 2015 Porsche 911, VIN 6. The following real property associated with XIULU RUAN, . 2800 01111101113611 Ct. Mobile, Alabarna; B. 1301 Leroy Stevens Road, Mobile, Alabama; 7. The following real property associated with OHN PATRICK COUCH, M.D.: A. 319Woodbr'1dge Drive Daphne, Alabama; B. Unit 25040 Perdido Beach Orange Beach, Alabama; C. Unit 28105 Perdido Beach Orange Beach, Alabama. 8. A money judgment against JOHN PATRICK COUCH, MD. and XIULU RUAN, M.D., repreSenting a sum of money equal to the gross proceeds the Case 1:15?mc?01004 Document 4?3 Filed 04/30/15 Page 12 of 14 defendants obtained, directly or indirectly, as a result of a violation of Title 18, United States Code, Section 1349. All pursuant to the provisions of Title 28, U.S.C., 2461, and Title 18, U.S.C. 9872(a)(7 )1 SUBSTITUTE ASSETS If any of the property described above as being subject to forfeiture, as a result of any act or omission of the defendants, JOHN PATRICK COUCH, MD. and XIULU RUAN, M.D., cannot be located upon the exercise of due diligence; has been transferred or sold to, or deposited with, a third party; (0) has been placed beyond the jurisdiction of the court; has been substantially diminished in value; or has been commingled with other property which cannot be divided without dif?culty; it is the intent of the United States, pursuant to Title 21, United States Code; Section 853(p), as incorporated by 18 U.S.C. 982(b)(l), and 28 U.S.C. 2461, and Rule 32.2 Fed. R. Crim. P., to seek forfeiture of any other pr0perty of said defendants up to the value of the forfeitable property described above. . A TRUE BILL #6 FOREMAN, UNITED STATES GRAND JURY SOUTHERN DISTRICT OF ALABAMA KENYEN R. BROWN UNITED STATES ATTORNEY by: Vicki M. Davis - Assistant US. Attorney Chief, Criminal Division 10 4?3 Filed 04/30/15 Page 13 of 14 Document A Deborah A. Grif?n Assistant US Attorney pher S. Attorney H- Assistant U. APRIL 2015 11 Case 1:15?mc?01004 Document 4-3 Filed 04/30/15 Page.14 of 14 ?i PENALTY PAGE CASE STYLE: - UNITED STATES v. COUCH, et a1. DEFENDANTS: JOHN PATRICK COUCH, M.D. XIULU RUAN, MD: USAO NUMBER: 13R00521 AUSAs: DEBORAH A. GRIFFIN CHRISTOPHER J. BODNAR STATUTE: Count 1: 21 U.S.C. 846(a) (Conspiracy to distribute controlled subs.) commit healthcare fraud) 18 U.S.C. 1349 (Conspiracy Count .2: PENALTY: Count 1: Count 2: FORFEITURE: Notices Provided in Indictment 12