The investigation initially focused on a Miami Psychiatrist who wrote $43 Million worth of prescriptions from 2004-2009. It was calculated that psychiatrist Fernando Mendez-Villamil wrote an average of 153 prescriptions a day for 18 months ending in March 2009. On June 21, 2010 the Florida Agency for Health Care Administration terminated its Medicaid contract with Mendez-Villamil.
As a result, stories regarding top prescribers have now been published on 22 states and the District of Columbia: Alabama, Arizona, California, Connecticut, DC, Florida, Indiana, Iowa, Maryland, Minnesota, Mississippi, Montana, Nebraska, New Jersey, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia, Wisconsin (see below)
January 2, 2011, Washington Post
Montgomery County police in 2000 found a woman fading in and out of consciousness in a house so squalid it would soon be condemned as unfit for human habitation. At the hospital, the patient, who had attempted suicide before, was found to be full of booze and the same type of medications that had been prescribed by Joel Cohen, who, as it turned out, was her fiance.
For more than a year, Cohen, then a psychiatrist in Bethesda, had been prescribing the woman medications such as hydrocodone and the anti-anxiety drug diazepam but failed to keep records, according to the Maryland Board of Physicians, which placed him on probation in 2001.
In February 2006, that probation was lifted. Five months later, Cohen was sanctioned again after what the board called a “dangerous failure to meet the standard of care” with a second patient, for whom he prescribed “large amounts of medications” despite her history of alcohol and prescription drug abuse. Cohen did this, according to the board, even while he “was aware that the patient was abusing prescription medications,” including the stimulant Ritalin.
In 2008, according to the D.C. Board of Medicine, Cohen was the District’s top prescriber under Medicaid of three antipsychotic medications: Seroquel, Abilify and Geodon.
In the 2006 sanction, the Maryland board said Cohen had committed “egregious boundary violations” with the patient, a victim of spousal abuse who had developed borderline personality disorder. He gave gifts to her children, allowed her to take his children on vacation and gave her real estate advice. He also let the patient, whom he had been treating for 21 years, shower at his office and prescribed Ritalin for her son without evaluating him.
Cohen admitted to the board that he had “mishandled the patient’s case in many ways and had underestimated his own difficulties,” according to the board’s final order in the case.
In that second sanction, the board said Cohen’s actions “were not a one-time, short-term lapse of judgment with one patient, but rather a longstanding, documented pattern of unethical behavior dating back to 1977.”
Cohen’s license in Maryland has expired, but he continues to practice at Community Connections, a clinic on Capitol Hill.
One patient’s fiancee asked the doctor to please stop prescribing so many medications. The patient was an alcoholic with a history of abusing narcotics and sedatives. Once, he overdosed, and now he was in a detox clinic. Still, the doctor did not stop prescribing, according to Maryland’s Board of Physicians.
January 2, 2011, Alabama, Montgomery Advertiser
Grassley requested data about the top 10 Medicaid prescribers of Abilify, Geodon, Seroquel, Zyprexa, Risperdal, OxyContin, Roxicodone and Xanax from each state. He wanted to know each prescribing physician’s identifier number, the number of prescriptions per drug each physician had written for 2008 and 2009, and the total amount billed to Medicaid per drug.
What Grassley would find from some of the states that complied with his request is that some physicians were writing thousands of prescriptions for these drugs. He also found that some of these same physicians were being investigated for fraud, or had been kicked out of their state Medicaid programs for fraud.
In Florida, for example, a physician was found to have written 96,685 prescriptions for mental health in 21 months. Grassley’s office calculated that this physician would have had to write more than 150 prescriptions a day, seven days a week and no vacations for almost two years.
Alabama’s top providers
Abilify, Risperdal and Zyprexa appear to be the prescription drugs that these top 10 physicians were paid the most for prescribing. Several physicians were paid between $400,000 and just more than $740,000 in some years for prescribing these drugs.
January 1, 2011, Iowa, Cedar Rapids Gazette
Ten doctors in Iowa wrote 23,220 prescriptions for eight painkillers, anti-anxiety and antipsychotic drugs in 2008, valued at nearly $4.7 million. Those numbers increased to 32,358 prescriptions and $6.1 million in 2009.
Waterloo psychiatrist Dr. Marvin Piburn Jr … who works at the Black Hawk-Grundy Mental Health Center in Waterloo, the Independence Mental Health Institute and several other northeast Iowa clinics, was the top prescriber of Xanax in 2008 and 2009.
The 915 Xanax prescriptions he wrote last year pales in comparison to a Texas doctor who wrote 14,170 prescriptions for the same anti-anxiety drug that year.
A Miami doctor who wrote nearly 97,000 Medicaid prescriptions in 18 months for mental health drugs and an Ohio physician who wrote about 102,000 prescriptions in two years were the types of cases that precipitated Grassley’s investigation.
Child psychiatrist Dr. Larry Richards … was the top Abilify prescriber in 2009, with 844 prescriptions.
With a paid amount of more than $1.9 million for the top 10 prescribers in 2009, the drug led Iowa’s list in cost.
December 16 2010, Iowa, Cedar Rapids Gazette
Medicaid oversight questions
December 13, 2010 Iowa, Cedar Rapids Gazette
Grassley: ‘Widely abused’ drugs overprescribed
Dec. 11, 2010, Texas, Fort Worth Star Telegram
Some doctors handing out prescriptions to kids for potent medications
December 12, 2010, Nebraska, Omaha World Herald
Oversight urged on pill orders
Dec. 9, 2010, South Dakota, Washington Examiner
Excerpts from recent South Dakota editorials
December 6, 2010, California, The San Diego Union-Tribune
3 local MDs are paid experts, also prescribe the drugs
December 6, 2010, California, California Watch
Top antipsychotic prescribers are also drug promoters
December 5, 2010, Mississippi, The Clarion-Ledger
Mental health drugs probed
December 5, 2010, South Dakota, Rapid City Journal
State snubs feds in doctor probe
December 2, 2010, Tennessee, Nashville Scene
TN Won’t Turn Over Names of Top Prescribers To Senate Committee
December 1, 2010, South Dakota, Rapid City Journal
State ignores Senate request for medical data
December 1st, 2010, Tennessee, The Kingsport Times-News
Tenn. won’t release names of doctors who write most prescriptions
December 1, 2010, Tennessee, News Sentinel
Tennessee won’t give doctors’ names to senator
December 1, 2010, Tennessee, The Tennessean
TN won’t release names of doctors who write most prescriptions
Nov. 30, 2010, Tennessee, Chattanooga Times Free Press
November 24, 2010, Nebraska, Lincoln Journal Star
The cost of mental health? Pricey
Nov 23, 2010, South Carolina, From the NBC News Political Unit
An influential U.S. senator is checking up on South Carolina doctors
November 22, 2010, South Carolina, Charleston Post & Courier
November 22, 2010, South Carolina, Charlotte Observer
S.C. doctors might be over-prescribing
November 22, 2010, South Carolina, The State
Nov. 22, 2010 , South Carolina, The Herald
November 22, 2010, South Carolina, Sun News
November 18th, 2010, Montana, Alabama, Wisconsin and New Jersey, Pharmalot
States Refusing To Give Medicaid Data To Grassley
November 17, 2010, Connecticut, Journal Inquirer
Beleaguered doc was biggest Medicaid prescriber of pain ‘lollipop’
Nov 15, 2010, Indiana, Indianapolis Star
November 14, 2010 Oklahoma, The Oklahoman
Senator scrutinizes top Oklahoma prescribers of pain, anti-psychotic medications
November 5, 2010 Alabama, Tuscaloosa News
EDITORIAL: Why are doctors writing so many prescriptions?
November 1, 2010 Connecticut, Hartford Courant
Senator Grassley Cites Connecticut Example Of Doctors Who Write Too Many Prescriptions
October 30, 2010 Pennsylvania, Pittsburgh Tribune-Review
Feds eye doctors’ prescriptions for drug fraud
October 30, 2010 Arizona, Arizona Daily Star
State provides spending data on prescription drugs to senator
October 28, 2010 Arizona, Arizona Daily Star
Arizona provides prescription drug spending data to U.S. Senator
October 28, 2010 West Virginia
Editorial: Senator asks good questions about prescription drugs
October 23, 2010 Minnesota, Star Tribune
Top prescribers under Senate’s microscope
October 21, 2010 Florida, El Nuevo Herald
Psiquiatra de Miami en el centro de polémica por fraude con recetas al Medicare
October 21, 2010 Florida, Miami Herald
Another volley in Rx probe
October 21, 2010 Florida, AP
December 27, 2009 Florida, St. Petersburg Times
December 18, 2009 Florida, Miami Herald
December 17, 2009 Florida, AP
December 16, 2009 Florida, Miami Herald
Miami psychiatrist cited in letter blasting health services monitoring