Eleven individuals were indicted by a federal grand jury for conspiracy to distribute controlled medications, such as oxycodone, without a legitimate medical purpose; obtaining controlled medication by deceit and subterfuge; paying and receiving illegal kickbacks for referrals to lab for urine tests of the patients; and submitting false claims to Medicare and other health insurers. According to the indictment, Dr. Asim Muhammad Ali and Dr. Stanley Librach, medical doctors, and Dr. Jerry Dale Leech, a chiropractor, and Denis J. Mikhlin illegally wrote and distributed hundreds of prescriptions for oxycodone, oxycontin, hydromorphone, and fentanyl for patients whom Dr. Ali and Dr. Librach did not see, examine, or evaluate. One day a week for about two hours, Dr. Ali or Dr. Librach came into the American Pain Institute (API) and later Institute for Pain Management (IPM) and pre-sign stacks of prescriptions, which were given to API and IPM patients during the next week or two. Dr. Ali and Dr. Librach continued to write prescriptions for controlled substance drugs although many patients repeatedly tested negative for the prescribed drugs and positive for illegal street drugs.