MONTGOMERY, AL (WSFA) - The federal pill mill case involving a Montgomery nurse practitioner, Lillian Akwuba, wrapped up day five of testimony late Thursday afternoon.
Three of the nurse practitioner's former associates testified as government witnesses about Akwuba's patterns and practices.
Akwuba worked for well-known Montgomery doctor Gilberto Sanchez. Thursday's testimony focused on her time after she left Family Practice and opened her own clinic called Mercy Family Care.
Dr. Eugene Essandoh testified that he and his wife made an investment into Akwuba’s practice. While his name was on the sign, he didn’t see patients and later learned Akwuba was billing under his physician number and his wife’s to get larger medical reimbursements for her medical care.
Dr. John MacLennan, 82, testified that Akwuba sought him out for a collaborative agreement that would allow her to operate as a nurse practitioner after working with her briefly in hospice care. He signed an agreement to review charts and sign prescriptions in June 2016. The agreement would give MacLellan 10 percent of the practice’s profits after expenses.
Maclellan drove to the practice multiple times, and was given prescriptions to sign, but never given access to patient information, despite his best effort.
MacLellan testified that he even wrote down names and birthdays of the patients and attempted to access the records from home but was unsuccessful.
He cited his concern over the amount of narcotics Akwuba was prescribing and brought her a book from his library, "Responsible Opioid Prescribing", in an effort to better educate Akwuba.
Maclellan said in his family medical practice he wrote four to five narcotic prescriptions a week, but Akwuba wrote more than 20 a week, which was a red flag. Also citing concern that the prescriptions were for chronic care, not acute care or cancer treatment.
The prosecution presented evidence of nearly 10 prescriptions that he signed, that were drawn up by Akwuba.
On Aug. 23, 2016 MacLellan made the decision to terminate his collaborative agreement with Akwuba.
“After having many attempts to access records, no proof of urine drug screens, no PDMP material, I became alarmed and felt it was unsafe,” MacLellan stated.
McLellan drove to the Alabama Board of Medical Examiners and asked to terminate the agreement.
“I told them there this woman is running a pill mill,” MacLellan stated. “I said five times she was running a pill mill.”
The government then presented other prescriptions that were signed with his name after the agreement ended. MacLellan testified that he never signed those prescriptions.
MacLellan is under federal indictment for conspiracy to violate the controlled substances act.
Akwuba's former case manager at Mercy Family Health Care, Courtney Glass, also testified about her experience working for the defendant.
Glass stated she and Akwuba had arguments over coding for medical care, stating Akwuba was attempting to bill for the highest code, or amount possible.
Glass also testified that Akwuba’s medical records lacked information to properly code for medical reimbursement, and often saw prescriptions for controlled substances, stating patients were paying $75 for prescriptions at the office.
When questioned about Akwuba’s patterns of prescription writing, she stated some of the pads were presigned, and witnessed Akwuba forging a doctors' signatures on prescriptions.