Tennessee doctor and pastor convicted of extensive drug dealing at 'pill mill' clinic

NASHVILLE, Tenn. — A Tennessee doctor and pastor was convicted of three dozen federal felonies this month in an extensive drug dealing case involving hidden cameras, spiked urine, countless copied-and-pasted medical records and two patients suffering drug overdoses in the doctor’s waiting room.

Dr. Samson Orusa, who for decades owned a rundown pain clinic and led God’s Sanctuary Church International, both in Clarksville, Tennessee, was convicted of a single count of “maintaining a drug-involved premises” and multiple counts of unlawful distribution of a controlled substance, health care fraud and money laundering. His sentencing hearing has not yet been scheduled.

Orusa was convicted on Aug. 13, but the verdict hasn't been publicly reported until now. The U.S. Attorney’s Office for the Middle District of Tennessee didn't publicize the verdict, despite normally touting convictions like this one as victories for the public.

David Boling, a spokesman for the office, said prosecutors could not comment on the case because the jury had not yet been dismissed. Court records show jurors are still empaneled to consider whether to seize the contents of seven bank accounts, which prosecutors allege are filled with drug profits that Orusa eventually will transfer overseas.

Prosecutors say Orusa's clinic, where he was the only medical provider, generated about $50,000 in profit a week due to a combination of fraud and “volume-focused, turnstile patient care” that involved “fictitious” exams and Orusa spending “notoriously little time with his patients."

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Miller Bushong, an assistant U.S. attorney who prosecuted the case, wrote in court records that both drugs and urine were sold on the clinic property, and dirty syringes were strewn across the parking lot.

“The clinic was not a place for patient care, treatment and healing, but rather an open market for the sale of pain pill prescriptions,” Bushong wrote.

Orusa’s attorney, Peter Strianse, did not respond to requests for comment.

'One of the worst' opioid prescribers in Tennessee

Law enforcement in Tennessee have pursued Orusa for years. He was previously indicted on health care fraud allegations after federal agents raided his clinic in 2004, but these charges were dismissed through a diversion agreement after a seven-day trial in 2008.

At the time, Orusa said he had been protected by God.

"It's not every day someone comes out of this situation,” Orusa said. “It was shocking, difficult and painful, but we saw God taking care of us when we thought we were finished."

Orusa was indicted in his current case, with more severe allegations, in 2018. Soon after the indictment, then-U.S. Attorney Don Cochran said Orusa's clinic was a "pill mill" and Orusa was “one of the worst” opioid prescribers in the state.

Once again, Orusa took his case to trial.

During testimony earlier this month, Dr. Gene Kennedy, an expert witness who reviewed medical records from two dozen of Orusa's patients, said that instead of conducting true examinations, it appeared Orusa merely copied and pasted identical records for each visit and “almost” all of his patients.

One patient’s records showed 92 separate exams with identical results, Kennedy said. Another had 156.

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“It is possible that the patient might have 15 identical physical exams,” Kennedy testified. “But the point is that these 15 identical physical exams are identical to essentially all of the other patients who have identical physical exams, which, in my opinion, is not credible.”

Undercover agent spiked his pee, but still passed a drug test

Orusa also appears to have ignored the results of urine drug screenings, a routine tool used to ensure pain clinic patients take their medication appropriately.

For example, some patients tested positive for addictive drugs they were never prescribed, but their test results were marked as "satisfactory" and Orusa kept prescribing them opioids anyway, Kennedy said. Other drug tests were deemed "unsatisfactory," and yet Orusa kept prescribing then too, Kennedy said.

Orusa’s clinic was also probed by an agent from the Tennessee Bureau of Investigation who went undercover as a new patient with a hidden camera. The agent described patients given opioid prescriptions at “cattle calls,” and said he was prescribed opioids and muscle relaxers without ever being seen by a doctor, according to federal court documents.

That agent also spiked his own urine sample with opioid drops, but Orusa’s clinic still documented his drug test as negative, Kennedy testified.

In another instance, a patient suffered a heroin overdose inside Orusa’s clinic that required her to be rushed to a hospital, Kennedy testified. When that patient returned for her next visit, Orusa did not bother to give her a drug screening before writing her more prescriptions, Kennedy said.

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Orusa's Medicaid billings a 'solar impossibility'

In addition to his flimsy prescriptions and fake medical records, prosecutors argued Orusa claimed to do the impossible – work more than 24 hours a day.

And he billed the government for it.

On Oct. 18, 2017, Orusa claimed to have treated 57 patients with Medicare coverage in a single day, then sought federal reimbursement for 24 hours and 15 minutes of work, court documents state. Prosecutors described this as “a solar impossibility” in court records.

“Adding to the impossible,” the records continued, “on that same day, (Orusa) wrote controlled substance prescriptions to 103 non-Medicare patients. Accordingly, documentary evidence establishes that Defendant processed 160 patients through his clinic on that single day.”

What Orusa didn’t know, however, is that law enforcement were already watching him. Federal agents had mounted secret cameras outside of his clinic one month prior to monitor his comings and goings.

Court records state that, on the day Orusa supposedly treated 160 patients over 24 hours, the cameras showed he was at the clinic for only six hours.

Follow Brett Kelman on Twitter: @brettkelman.