Miami Area Doctor Under Investigation

Last month a Miami psychiatrist came under the scrutiny of Senator Charles Grassley’s senate committee investigating conflicts of interest in psychiatry. This psychiatrist, although unnamed by the Senator, is reported to be one Fernando Mendez-Villamil.

Senator Grassley’s investigation had at this point, according to an article in The Miami Herald, Another volley in RX probe, evolved into an exploration regarding why some psychiatrists write so many prescriptions for federally funded Medicaid and Medicare programs.

In his latest volley, a letter sent Wednesday to Kathleen Sebelius, secretary for the U.S. Department of Health and Human Services, Grassley demanded exact answers to three pointed questions about what her department is doing to address the problem.

One of the doctors prescribing drugs for people on Medicaid and Medicare was–you guessed it–Dr. Mendez-Villamil. Dr. Mendez-Villamil wrote a whole heck of a lot of prescriptions over a period of less than 2 years. The figure given approaches 100,000.

In the Sebelius letter, Grassley said his concern was triggered by a “Florida provider who wrote 96,685 prescriptions for mental health drugs in a 21-month period.” The letter did not identify the provider, but state records confirm that it is Fernando Mendez-Villamil, a psychiatrist with an office on Coral Way.

Dr. Mendez-Villamil is reported to have written almost twice as many proscriptions as his closest competition in the area of filling out Medicaid paid prescriptions for psychiatric drugs.

The Florida Attorney General’s office has been conducting an ongoing investigation of Dr. Mendez-VIllamil. Dr. Mendez-Villamil has been terminated from the Medicaid program, but he is suing to have his cases again covered by Medicaid.

Last December, Grassley’s office calculated Mendez-Villamil’s numbers meant “this physician wrote approximately 153 prescriptions each and every day, assuming he did not take vacations.”

Earlier this year, Mendez-Villamil told The Herald that he works long hours and often gives each patient four or five prescriptions, accounting for the large numbers.

The practice of prescribing multiple psychiatric drugs to a single patient is known as polypharmacy. Polypharmacy is notorious for it’s predominately negative outcomes.

In April, Grassley wrote to all state Medicaid agencies requesting data about certain mental health drugs. On Wednesday, Grassley’s office said the Florida provider identified by The Herald as Mendez-Villamil had the second-highest number of prescriptions in the nation for the generic form of Xanax in the data they analyzed.

The Wednesday letter also noted that the top Zyprexa provider in Florida wrote 1,356 prescriptions for 309 individuals in 2008 and 1,238 for 236 in 2009. The Herald independently verified from state data that this provider was Mendez-Villamil, and he wrote more than twice as many Zyprexa prescriptions as the No. 2 provider in the state.

This doctor has done much of his prescribing to poor people as only poor people are covered by Medicaid and Medicare. Psychiatric drugs are often disproportionally prescribed to poor people, and given single solution doctors like Dr. Mendez-Villamil, one can easily see why this is so.