March 27, 2010
The Florida Agency for Health Care Administration (AHCA) is reporting that a Miami psychiatrist has prescribed nearly 14 million pills to Medicaid patients since 2004. According to the report, Fernando Mendez-Villamil wrote about 285,000 prescriptions in just six years with a total taxpayer cost of $43 million.
The astounding find is part of an investigation into the legitimacy of Mendez-Villamil's practice; after all, the numbers suggest that he would have had to prescribe about 4,000 prescriptions a month, or 1,000 a week, in order to achieve the large total.
Mendez-Villamil is already recognized as the most profuse drug prescriber in the state of Florida. Prior to the state's implementation of new computer tracking protocols around 2007, Mendez-Villamil's prescription rate was at its highest; after those measures began taking effect, his prescription rate slowed by almost 33 percent.
Mendez-Villamil's highest year was 2004 when he issued over 62,000 prescriptions totaling $12.2 million. The numbers averaged out to almost 2,700 patients that year who all received roughly 23 prescriptions each. When all was said and done, each patient received an average of 1,200 pills in 2004.
Senator Don Gaetz (R-Niceville) instigated the AHCA review into Mendez-Villamil, alleging that he is taking advantage of the system and wasting taxpayer money for illegitimate purposes. Sen. Gaetz is citing the case as evidence that better oversight of the Medicaid system is needed. In response to a freedom-of-information request, the in-depth review he requested was published in Health News Florida.
When recently contacted about the issue, Mendez-Villamil refused to speak to the media. His attorney made a statement in his defense, insisting that all such numbers are normal for the volume of patients seen by the doctor. Mendez-Villamil did personally speak to the media back in December, however, where he explained that he typically sees patients for about 10 minutes every few months which allows him to see a large number of patients. Most of these patients, he said, are on four or five drugs each, all of which he says are necessary.
According to the report, Mendez-Villamil often prescribes some of the most expensive psychotropic drugs to his patients, including Zyprexa which costs about $840 for a 30-day supply. Other common prescriptions include Abilify at over $630 a month and Seroquel at $430.
In 2007, the Bureau of Medicaid Program Integrity received a complaint about Mendez-Villamil which it handed over to the Attorney General's Medicaid Fraud Control Unit. The investigation is still in progress but, since receiving more intense scrutiny, Mendez-Villamil has reduced his number of patients by 25 percent.