Psychiatrist faces Grassley's wrath over Medicaid prescribing

Pills in blisters

A Miami psychiatrist has incurred the wrath of no less than Sen. Charles Grassley (R-Iowa), who argues that the doctor is dramatically over-prescribing medications for Medicaid patients.

Grassley sent a letter to federal Medicaid officials criticizing the physician, who wrote 96,685 prescriptions between the last half of 2007 and the first quarter of 2009 for his Medicaid patients. The letter from Grassley comes as part of a larger effort by legislators to put teeth in health reform by lowering costs.

While the letter doesn't mention the doctor by name, the Miami Herald concluded that the physician is Fernando Mendez-Villamil. Mendez-Villamil wrote almost twice as many prescriptions for psychiatric drugs as the second most heavy prescriber in the state.

None of the drugs he commonly prescribes--such as Zyprexa, Abilify and Seroquel--have any significant street value, so he couldn't be accused of being a "drug dealer" for medication-seeking patients. And he's not getting rich on caring for these patients, certainly, as Medicaid pays only $45 per office visit.

Mendez-Villamil told the Herald that part of the reason for the high volume of prescriptions is that psych patients often need four or five medication scripts. And the state agency monitoring Medicaid doesn't feel that there's anything improper going on here. Could Mendez-Villamil be a scapegoat? Seems possible.

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