Two pain docs arrested for urine drug toxicology testing fraud

PPSA patients waiting in line (Fox10 News)

Patients waiting in line outside PPSA on May 21, 2015 (Fox10 News)

“We are committed to the highest standard of patient care.”  That is a quote from the website of Dr. John Patrick Crouch and Dr. Xiulu Ruan of Physicians’ Pain Specialists of Alabama (PPSA), who were arrested on May 20, 2015 by federal agents after being indicted on charges of unlawful distribution of controlled substances and healthcare fraud related to urine drug toxicology (UDT) testing.

Unfortunately, not many details are available in the indictment, Department of Justice press release, and various media reports, but I am sure more will come out as the case progresses.  Like other cases involving health care fraud (alleged, proven and/or admitted) I have discussed on the site, the lifestyles of the involved parties is quite fascinating (see below).

Drs. Couch and Ruan were arrested as part of “Operation Pillution”, a federal law enforcement effort aimed at prescription drug abuse in the southern US. On the day the two were taken into custody, federal agents conducted raids on multiple pain clinics and pharmacies in Arkansas, Alabama, Louisiana and Mississippi.

Indictment Contents

Distribution of Controlled Substances

In addition to owning PPSA, Drs. Couch and Ruan also own C&R Pharmacy, which I believe is located in the same building as PPSA.


Dr. John Patrick Couch (

Starting in about January 2011, Drs. Couch and Ruan allegedly conspired to distribute and dispense numerous Schedule II controlled substances “outside the usual course of professional practice and not for a legitimate medical purpose”.

[Continue reading]

Jury awards couple almost $10 million for misread Pap tests

A jury in southwestern Maine needed to deliberate for only about 75 minutes before it awarded $7.65 million to a woman whose diagnosis of cervical cancer in 2011 was delayed by several years due to misread Pap tests. Her husband was also awarded $2 million for loss of consortium. I contacted the plaintiffs' attorney and asked for a copy of the complaint, but I have not heard back yet.  So unfortunately, the only information I have about the case comes from various media reports.  If the … [Continue reading]

Pathology Blawg News Roundup for May 22, 2015

Urologist Dr. Deepak Kapoor still fighting to preserve inappropriate self-referral The Journal of the American Medical Association recently published a response penned by urologist Dr. Deepak Kapoor to the recent editorial that advocated for closure of the in-office ancillary services exception to the Stark Law.  While his arguments are easily debunked, they once again show Dr. Kapoor is a master at defending the indefensible. Kapoor:  "Even though the Government Accountability Office … [Continue reading]

Health Diagnostic Laboratory files $66 million-plus counterclaim against Cigna

Health Diagnostic Laboratory (HDL) has filed a counterclaim against Cigna, alleging the health insurer owes at least $66 million in unpaid laboratory services.  The counterclaim was filed as part of a response to the suit Cigna filed against HDL in October 2014 that alleges HDL unlawfully extracted at least $84 million from it via an unlawful fee-forgiveness scheme. Factual Allegations HDL takes issue with claims from 2013 to the present day involving both fully insured plans and … [Continue reading]

Whistleblower allegations against Family Dermatology/Nelson Dermatopathology

Dr. Paula Nelson being confronted by a reporter (

A couple of weeks ago I wrote about the Department of Justice press release that announced Family Dermatology, which also operates a dermatopathology laboratory called Nelson Dermatopathology, had agreed to pay a little more than $3.2 million to settle allegations it violated the False Claims Act. At the time, the whistleblower suits that contained the allegations were not yet on PACER, so I could not get into any more detail than was provided by the DOJ.  But now I have the three suits in … [Continue reading]

Federal Trade Commission will not challenge testimony of former Tiversa forensic analyst

The Federal Trade Commission (FTC) has determined it will not challenge the testimony given last week by Mr. Richard Wallace, the former forensic analyst for data security company Tiversa, who stated Tiversa's CEO, Dr. Robert Boback, directed him to fabricate evidence the FTC used against uropathology laboratory LabMD in an administrative action that eventually led to LabMD's closure. I reached out to Mr. Mike Daugherty, the owner of LabMD, and Dr. Boback, and both were kind enough to provide … [Continue reading]

Former Tiversa employee admits to fabricating LabMD evidence

Richard Wallace, a former employee of data security company Tiversa, testified last week that he, at the behest of Tiversa CEO Robert Boback, fabricated evidence the Federal Trade Commission (FTC) used against uropathology laboratory LabMD in an administrative action that eventually caused LabMD to close its doors. Background The dispute involving LabMD, Tiversa and the FTC has been going on for years now.  I have discussed much of what has transpired recently in a series of posts that … [Continue reading]

Physician accuses pharmacogenetics laboratory Renaissance RX of fraud during DART study

Dr. Scott Wilson, a Rhode Island internist, has filed a lawsuit against Louisiana-based pharmacogenetics laboratory Renaissance RX (Ren RX) that alleges the company engaged in fraud related to the Diagnosing Adverse Drug Reactions Registry (DART) study.  Syntactx, a "contract research organization that specializes in medical device trials", is also named as a defendant in the suit. As I mentioned in a January 2015 post about a lawsuit filed by Ren RX's former CEO that accuses the company's … [Continue reading]

Pathology Blawg News Roundup for May 8, 2015

Visabl logo

College of American Pathologists to introduce legislation to change local coverage determination process The College of American Pathologists (CAP) is dissatisfied with the process by which local coverage determinations (LCDs) are finalized, and has drafted legislation to remedy the perceived shortcomings. I can only presume this is in response to the LCD issued by Medicare Administrative Contractor Palmetto GBA that pertains to pathologist utilization of ancillary and special stains. … [Continue reading]

“Absolute, complete dissatisfaction” with UnitedHealthcare/BeaconLBS pilot program

Modern Healthcare published an interesting article a few days ago about the Laboratory Benefit Management Program (LBMP) pilot in Florida created by UnitedHealthcare (UHC) and LabCorp subsidiary BeaconLBS that quotes a spokesperson for the Florida Medical Association as saying there is “absolute, complete dissatisfaction" with the program. I am currently out of town and cannot write very much about the Modern Healthcare article, but here are some of the take-home points: The LBMP … [Continue reading]

Jury finds Millennium Health infringed on Ameritox patent; awards $8.65 million

A jury in Madison Wisconsin recently found Millennium Health (MH) infringed on a patent licensed to rival Ameritox and ordered it to pay $8,562,760. The patent in question, #7,585,680 ('680), was invented by Dr. Michael Larson and Dr. Thomas Richards, both of the Marshfield Clinic, and describes: ...methods for detecting and quantifying metabolites in a biological sample by measuring the concentration of a test metabolite in the sample and comparing that concentration against the … [Continue reading]

Pathology Blawg News Roundup for May 1, 2015

In-office dermatopathology lab owner to pay more than $3.2 million to settle alleged False Claims Act violations The Department of Justice recently announced Family Dermatology, which has offices and a dermatopathology lab in Georgia, and additional offices in Maryland and Pennsylvania, will pay $3,247,835 plus interest to settle allegations it violated the False Claims Act. This announcement was made on April 21, but I had been waiting for the three qui tam suits from which the … [Continue reading]

Two claims from narrowed antitrust suit against Quest Diagnostics allowed to proceed

Quest logo new

A federal judge in northern California will allow only two claims, one from Hunter Laboratories and the other from Surgical Pathology Associates (SPA), to proceed in an antitrust suit they filed against Quest Diagnostics back in November 2012. Background This case was originally filed by four plaintiffs— Rheumatology Diagnostics Laboratory (RDL), Pacific Breast Pathology Medical Corporation (PBP), Hunter Labs and SPA—and contained 8 causes of action against Quest, Aetna, Blue … [Continue reading]

Aetna sues Health Diagnostic Laboratory and Bluewave Healthcare Consultants

In a lawsuit filed earlier this month, health insurer Aetna seeks to recover "tens of millions" of dollars from Health Diagnostic Laboratory (HDL) and its sales contractor Bluewave Healthcare Consultants, claiming they paid illegal kickbacks to physicians and encouraged them to order unnecessary tests, and provided unlawful inducements to patients. This lawsuit follows closely on the heels of the announcement from the Department of Justice that HDL will pay at least $47 million and could … [Continue reading]

College of American Pathologists officially responds to disclosure of its financial information

I received an email yesterday from the College of American Pathologists (CAP) which contained its official response to my post about its 2013 financial information.  I very much appreciate the CAP reaching out to me, and am hopeful it will provide a comment at some point on my most recent article concerning a few aspects of its operations. With permission, the full response is below. CAP Response: 2013 Financial Information The CAP is a large medical society comprised of 18,000 … [Continue reading]