Pain Clinic Doctor Arrested in Opioid Fraud Scheme Plans to Fight Charges

A Clarksville pain clinic doctor and pastor has been arrested in what federal prosecutors called a “massive” opioid distribution and fraud scheme.

A 45-count federal indictment was unsealed Thursday, charging Dr. Samson Orusa, 56, with maintaining druginvolved premises; 22 counts of unlawful distribution of a controlled substance outside the bounds of professional medical practice; 13 counts of healthcare fraud; and nine counts of money laundering, U.S. Attorney Don Cochran for the Middle District of Tennessee announced in a news release.

Orusa was arrested by federal agents Thursday and appeared before a U.S. Magistrate Judge late in the afternoon.

“Physicians who prey upon an already addicted population; steal from public healthcare programs; and engage in such reckless disregard for patient safety, as alleged here, will face a vigorous prosecution by this office,” Cochran said in the release. “Anyone who contributes to the opioid epidemic plaguing this nation should expect to be targeted by our law enforcement partners and held accountable.”

Plans to fight charges

According to the indictment, as early as January 2014, Orusa opened and maintained his medical practice at 261 Stone Crossing Drive in Clarksville for the purpose of distributing Schedule II controlled substances, including oxycodone, not for legitimate medical purposes and beyond the bounds of medical practice.

Orusa was booked by U.S. Marshals and released with an ankle bracelet and passport surrender, according to David Boling with the U.S. Attorney’s Office.

When reached at his office, Orusa declined to comment, referring questions to his attorney, Jim Todd of Nashville.

“Obviously he’s not in a position to respond because of the charges against him,” Todd told The Leaf-Chronicle, adding that the grand jury has only heard the government’s side of the case. “We plan on vigorously defending Dr. Orusa when the case is set for trial,” Todd said.

Meanwhile, Orusa is allowed to see patients but cannot write prescriptions. He is preparing to open a new office at 190 Hatcher Lane, Suite D.

Patients seeking prescriptions at Orusa’s office Friday morning were being turned away.

Overprescription of opioids

The new indictment alleges a pattern of conduct by Orusa whereby patients were prescribed oxycodone and other Schedule II controlled substances without obtaining the patient’s prior medical history; performing a credible physical examination or performing a diagnostic workup, the release said.

According to the indictment:

❚ February 2015: Orusa diagnosed a patient with chronic pain syndrome without performing a specific examination and prescribed oxymorphone (an opioid), Soma (carisoprodol, a muscle relaxer), and alprazolam (benzodiazepine, an anti-anxiety drug). This regimen is commonly referred to as “The Holy Trinity,” and is considered to be a potentially deadly drug cocktail. On Feb. 24, 2015, this patient died as a result of ingesting a like combination of drugs.

❚ April 17, 2018: A patient suffered a heroin overdose in the waiting room of Orusa’s medical office after Orusa prescribed oxycodone and other Schedule II controlled substances, without conducting proper examinations or checking the patient’s medical history.

❚ July 1-Aug. 21, 2018: Orusa wrote approximately 2,494 prescriptions for Schedule II controlled substances, among them oxycodone prescribed to patients identified as high-risk and to patients with questionable and falsified drug screens.

❚ Sept. 14, 2018: On the same day the State of Tennessee permanently revoked Orusa’s pain management certificate, Orusa wrote 164 individual prescriptions for approximately 12,754 Schedule II controlled substance pills.

Beginning in 2014, several pharmacies in Montgomery County refused to honor prescriptions for Schedule II controlled substances written by Orusa, the release said.

Medicare fraud charges

The indictment also alleges that beginning in 2014, Orusa devised and participated in a scheme to defraud health insurance benefit providers, including Medicare, by:

❚ Submitting upcoded reimbursement claims, indicating a higher level of service than actually performed.

❚ Submitting false and fraudulent claims to Medicare for services that were medically unnecessary.

❚ Causing claims to be submitted to Medicare for prescriptions that were issued in violation of law or otherwise outside the bounds of accepted medical practice.

❚ Diverting proceeds of the fraud.

The allegations include as part of the scheme, that Orusa would accept or see 50-60 patients or more in a single day; require insurance patients, including Medicare beneficiaries, to visit his office approximately four to six times in a single month in order to increase and inflate reimbursement claims, while cashpaying patients were only required to visit Orusa’s office twice per month; and required insurance patients, including Medicare beneficiaries, to accept injections, in order to increase and inflate reimbursement claims. Orusa threatened to withhold pain management prescriptions from insurance patients who refused the injections. Cash paying patients, however, generally were not required to accept injections in order to receive pain management prescriptions, the release said.

Finally, the indictment alleges that Orusa conducted financial transactions designed to disguise the nature of the unlawful activity and that he transferred or caused to be transferred proceeds of the unlawful activity to foreign bank accounts; used clinic proceeds to make a $12,451 down payment on a 2017 Mercedes-Benz; and wrote a check for the purchase of $100,000 in securities.

Sending a message

“The arrest of Dr. Orusa should serve as a warning to all doctors who fail to practice medicine in an ethical and responsible manner,” said D. Christopher Evans, Special Agent In Charge of DEA’s Louisville Field Division, which oversees DEA activity throughout Kentucky, Tennessee and West Virginia.

“The men and women of DEA are committed to using every available resource to stop the flow of drugs into our communities, especially when the drug dealer is a physician,” Evans said in the release.

If convicted, Orusa faces up to 20 years in prison on each drug-related count and up to 10 years in prison on each healthcare fraud and money laundering count.

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