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Florida Sanctions Top Medicaid Prescribers — But Only After A Shove

Medicaid programs have long had evidence that a few physicians prescribed risky drugs in excess, but it wasn’t until Sen. Charles Grassley, R-Iowa, demanded to know the top prescribers that states began to investigate.

File photo by STAN HONDA/AFP/Getty Images

At Dr. Huberto Merayo’s bustling psychiatry practice in Coral Gables, Fla., hundreds of poor patients on Medicaid walked away each year with prescriptions for powerful antipsychotic drugs.

Merayo’s prescriptions for the drugs totaled nearly $2 million in 2009 alone, state records show.

The 59-year-old psychiatrist is also in demand by the makers of these drugs. He’s earned more than $111,000 since 2009 delivering promotional talks for AstraZeneca, Eli Lilly & Co. and Pfizer, according to ProPublica’s database of drug-company payments to doctors.

This year, Florida regulators finally challenged Merayo’s enthusiasm for the pricey drugs, which are used to treat schizophrenia and bipolar disorder. A state review found he hadn't documented why patients were prescribed the pills and had given them to patients with heart ailments or diabetes despite label warnings.

In May, Florida summarily ended his contract with Medicaid. But the action, though decisive, followed years of high prescribing by Merayo, according Florida’s own statistics. And he was booted only after public questioning by U.S. Sen. Charles Grassley, R-Iowa, who had asked states to investigate such cases.

Merayo’s situation is one of at least three in which Florida allowed physicians to keep treating and prescribing drugs to the poor amid clear signs of possible misconduct.

The state’s responses were marked by head-scratching errors, including the misspelling of Merayo’s name on official documents, and lengthy delays.

In another example, Florida allowed Dr. Joseph M. Hernandez of Lake City to continue prescribing narcotic pain pills to Medicaid patients for more than a year after he was arrested and charged in 2010 for trafficking in them.

States pushed to act

Medicaid programs across the country have long had evidence that physicians have been prescribing risky drugs in excess and perhaps to the wrong patients. These prescriptions also racked up huge bills for the programs.

But like Florida, many states did not act on that evidence. Last year, Grassley demanded data from each state about its highest prescribers of pain pills and antipsychotics, and he asked state and federal officials to determine whether the prescriptions written by these doctors were legitimate.

Since then, states including Louisiana, Arizona, Oklahoma and New York have kicked some high-prescribing physicians out of Medicaid. California has temporarily suspended or placed restrictions on 15 to 20 doctors in the past two years for prescribing disproportionately high volumes of painkillers and antipsychotics to Medicaid patients.

Florida has been in sight lines of law enforcement, politicians and government officials because it is widely viewed as a hotspot for health-care fraud. Until recently, the state's lax rules allowed pill mills to proliferate, serving as a hub for painkiller distribution in Florida and beyond.

In April 2008, after much debate over the high number of children being prescribed antipsychotics, Florida began requiring doctors to get preapproval before giving the drugs to kids under age 6 in the Medicaid program. Since then, the number of such prescriptions written for kids has plummeted.

But the same level of scrutiny has not extended to prescriptions written for older Medicaid patients.

Florida health officials declined to discuss specific cases or answer detailed questions about why it has taken so long to investigate and sanction some physicians. State officials also would not detail the systems in place to alert them to troubling prescription patterns. The Florida Medicaid program serves about 3.2 million poor children, pregnant women and the disabled.

In a statement, the Florida Agency for Health Care Administration said it “employs a variety of detection tools to determine possible overutilization and other departures from peer group or utilization norms.”

One prescriber, $4.7 million

When psychiatrist Fernando Mendez-Villamil’s role as Florida’s top prescriber of antipsychotics became public in 2009, it made the local news. But documents show Florida had known since at least 2004 that Mendez-Villamil, who also heavily prescribed other drugs, was a problem.

It did not bar him from billing Medicaid until last year after Grassley made his prescribing record public.

Mendez-Villamil wrote more than 96,000 Medicaid prescriptions for mental-health drugs from July 2007 to March 2009, more than any other physician in Florida, according to a list compiled by Florida in June 2009 for Grassley.

Mental-health-drugs typically include antipsychotics, antidepressants and those to reduce anxiety.

In 2009 alone, Mendez-Villamil prescribed about $4.7 million in antipsychotics to Medicaid patients, according to state records.

Florida had been trying to get Mendez-Villamil to cut back his prescribing for years, according to a March 2010 letter from U.S. Health and Human Services Secretary Kathleen Sebelius to Grassley. The total Medicaid paid for all his prescriptions dropped by more than half from 2004 to 2008, she wrote, “Nonetheless the level of activity remains concerning.”

Yet, just months prior to Sebelius’ letter, a Florida Medicaid spokeswoman told The Miami Herald that Mendez-Villamil’s prescriptions didn’t “indicate that there is anything improper.”

Mendez-Villamil, who was officially terminated “without cause,” sued the state last year to have his Medicaid contract reinstated; the case is pending. His lawyer, Robert Pelier, said Mendez-Villamil was “collateral damage” in Grassley’s campaign.

“Dr. Mendez-Villamil doesn’t benefit by prescribing. He doesn’t get paid by the prescription. He doesn’t have any interest in generating [prescriptions] other than medication to keep the patient stable,” Pelier said.

In a 2010 letter to Grassley, Mendez-Villamil wrote that his prescriptions were justified by his busy practice. He worked at least 60 hours a week and saw patients every 10 to 15 minutes, he said. Most required prescriptions for two or three different drugs, he said, and refills made the numbers add up quickly.

Even though doctors aren't typically paid for prescribing a drug, there are other ways it can be lucrative.

Some doctors require patients to return often for refills, allowing them to bill for office visits. Others dispense drugs in lieu of spending more time with patients, allowing them to squeeze in more appointments. Still others have been arrested or convicted of selling access to their prescription pads.

Top prescriber despite sanctions

Hernandez was Florida’s top Medicaid prescriber for the painkiller oxycodone in 2009. In February 2010, he was charged with trafficking in the pills. He kept his license, however, and continued to rank among the state’s top Medicaid prescribers.

In July, Hernandez’s license was suspended. State officials found that 34 of his Medicaid patients had died — some from drug toxicity — since 2008, according to the state’s suspension order.

Moreover, Hernandez previously had been cited for medical lapses. In 2007, the Florida Department of Health barred him from performing surgery, saying he was legally blind in his left eye. The agency also fined him $5,000 for leaving a hollow needle or a portion of a catheter in a patient’s chest and not telling the patient or the medical staff at the hospital where the patient was transferred. And in 2009, he was fined $1,000 for failing to take a medical recordkeeping course.

Based on Florida’s action, the District of Columbia and Illinois revoked his licenses in 2007 and 2008. Florida then fined Hernandez $10,000 for failing to notify the state about the D.C. revocation.

Shelisha Coleman, a Florida Medicaid spokeswoman, said her agency was not told of Hernandez’s 2010 arrest until this year — even though state investigators were involved in the case. She could not explain why.

Hernandez’s attorney, Gilbert Schaffnit, did not return three calls seeking comment. He told The Miami Herald last summer that his client “is very diligent about the way he practices and prescribes, despite what the state would have you believe.”

Hernandez could not be reached. His criminal court case is pending.

Dumped from speakers’ circuit

In the case of Merayo, ranked second on Grassley’s list of Florida's high prescribers of mental-health drugs, the state found a variety of problems with his practice.

Some of Merayo’s patients told a reviewer they stopped taking the drugs he prescribed after being granted an exemption from taking the U.S. citizenship test. Immigrants can qualify for citizenship without taking the test if they can prove they are physically or mentally disabled.

A memo from a chief investigator for the Florida Agency for Health Care Administration does not say whether authorities suspect Merayo prescribed the drugs to create evidence of such a disability.

Yet, even when terminating Merayo, Florida had trouble getting it right. The state first informed him that he was being dropped as a Medicaid provider because his license had been suspended — even though it hadn’t been. Merayo’s license remains clean.

The letter also referred to him as "Humberto" Merayo instead of Huberto.

Medicaid subsequently gave a different reason. Merayo was told his Medicaid contract was being terminated “without cause,” something the state can do unilaterally, said his lawyer, Sean Ellsworth.

In a statement provided by Ellsworth, Merayo said he had not been “advised of any allegations involving billing irregularities” by Medicaid. He declined to comment on the allegations in the memo.

Among the companies that paid Merayo as a speaker, Eli Lilly said in an email message that it no longer uses him. AstraZeneca said it doesn’t plan to renew his contract for 2012, and Pfizer did not respond to questions.

ProPublica learned about the terminations of Mendez-Villamil and Merayo from Ken Kramer, a Florida Scientologist who runs a website devoted to exposing what he considers abusive practices by psychiatrists. Scientologists believe that the drugs used by psychiatrists “have no basis in science” and create “lifelong drug addicts,” according to the Church of Scientology website.

Feds walk a “fine line”

Officials at the U.S. Centers for Medicare and Medicaid Services, which works with state Medicaid programs and provides part of their funding, said they don’t keep track of high prescribers terminated by states. Each state administers its own program.

A partnership between states and the federal government, Medicaid provides health care to millions of low-income patients. Some doctors cater almost exclusively to Medicaid patients.

Angela Brice-Smith, director of the agency’s Medicaid integrity program, said her staff is working with some states to ensure the highest prescribers of antipsychotics are using the drugs appropriately, and to educate them if they are not.

“It’s sort of a fine line we’re treading,” she said. “We’re not trying to imply that we’re practicing medicine, but at the same time trying to share our observations.”

High rates of prescriptions do not always mean that physicians are doing something wrong. Some physicians, such as those working in busy urban mental-health centers, may indeed be prescribing properly. Each case needs to be reviewed separately, she said.

Medicaid programs spent more than $27 billion on prescription drugs in 2010, before rebates, according to federal statistics. As state budgets shrink, the pressure on states to “get the bad actors out” is growing, said Matt Salo, executive director of the National Association of Medicaid Directors. “There’s only so much you can do with a slap on the wrist.”

In an email message, Grassley said states need to use their own records to search for trouble.

“High numbers of prescriptions can indicate a busy medical practice with complicated patient needs, or they can indicate a problem,” he said. The government has an obligation to “get to the bottom of anything that looks questionable.”

I think the mention of “a variety of detection tools to determine possible overutilization and other departures from peer group or utilization norms” says a lot more than the Agency expected to reveal, namely that they either don’t take the issue seriously or the problem is widespread to the point that Merayo isn’t statistically interesting.

To explain, the only serious “detection tools” possible (barring surveillance or outright entrapment, the equivalent of cops hiring a kid to buy beer at a nightclub) are comparing statistical profiles:  How frequently does Dr. ABC prescribe Drug #N compared to Drug #M or Dr. XYZ (or as compared to a year ago), normalized for their case loads and specialties.  If one doctor overprescribing one drug isn’t easily findable, then it suggests that many doctors have been overprescribing many drugs.

The entire DHHS including the FDA, The CDC and the NIH are in the pockets of PhRMA.  The mass poisoning of the population is unprecedented and we as payers of health insurance premiums and consumers will pay while PhRMA walks away with billions in profits.  Our healthcare system cannot sustain this level of poisoning any longer.

Barry Schmittou

Nov. 17, 2011, 10:33 a.m.

Please email Senator Grassley at .(JavaScript must be enabled to view this email address) and ask him to investigate the doctors who ignore Multiple Sclerosis and cardiac conditions of many disabled patients as proven in quotes from numerous Federal Court Judges seen at http://www.deadlyorganizedcrimes.blogspot.com

The same crimes are destroying many injured workers lives in America.
WFAA – TV in Dallas Texas Wrote :

“a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care.”

ProPublica wrote these quotes about insurance companies destroying injured war zone contractors :

“Workers fought long battles for medical care, including such things as prosthetic devices and treatment for post-traumatic stress. One official called the system a “fiasco.”

“Labor officials can recommend cases for prosecution to the Justice Department–but have only done so once in the past two decades, according to Labor officials.”

See more evidence at :

http://www.treasonevidence.blogspot.com

Here are quotes from two Judges about MetLife’s Dr. Greenhood that are seen at the first website listed above :

U.S. District Judge Robert Cleland wrote that Metlife and their paid consultant Dr. Greenhood ignored a foot that Ms. Joanne Vick broke in 5 Places after she developed diabetic kytoacedosis following childbirth.

Judge Cleland quotes :

“Noticeably missing from Dr. Greenhood’s report is any mention of Dr. Al-Kassab’s November, 2001 office notes, Dr. Churchill’s November 13, 2001 office notes, and Dr. Churchill’s March 14, 2002 office notes. This is particularly significant in that Dr. Greenhood’s August 2, 2004 report specifically noted that “[t]here is no indication of seizures or falls.” Dr. Churchill’s March 14, 2002 report, however, indicates that as a result of her right sided weakness, Plaintiff broke her left foot in January 2002—in five places, no less.”

“Moreover, both Dr. Greenhood’s and Dr. Gosline’s reports contained numerous errors and inherent inconsistencies, which should have been noted by the plan administrator and resulted in less weight being given to them.

U.S. District Judge Timothy J. Savage wrote this in the case of Jacquelyn Addis :

“MetLife relied almost exclusively upon the report of Dr. Gary Greenhood, an internist specializing in infectious diseases hired by MetLife, who did not examine Addis and did only a records review. Dr. Greenhood selectively viewed Addis’s medical records, and MetLife then selectively adopted parts of Dr. Greenhood’s report to support denial of the claim.”

“Although the denial letter listed reports of several physicians, it relied exclusively on Dr. Greenhood, the internist it had retained, and gave little consideration to Addis’s treating neurologist, Dr. Tatarian. There is no discussion of the reports or findings of any of the other physicians who are listed.”

“Dr. Greenhood selectively extracted portions of Dr. Tatarian’s treatment notes to support his conclusions, which are contrary to those of Dr. Tatarian. At the same time, he ignores parts that bolster Addis’s complaints and support her doctor’s diagnosis and prognosis.”

He also ignores the MRI reports evidencing MS, November 2, 2000, and December 9, 2003. To the contrary, Dr. Tatarian documents a variety of spinal problems; and, MRIs consistently showed the presence of lesions and plaque on the brain. Dr. Greenhood ignores Dr. Tatarian’s report of a positive Babinski sign, which is indicative of nerve damage consistent with Addis’s complaints of stumbling and falling.”

“Both MetLife and Dr. Greenhood ignored the Multiple Sclerosis Medical Source Statement. Among the symptoms were pain in the lower extremities, fatigue, weakness and shaking in lower and upper extremities, poor coordination, bladder and bowel problems, blurred vision, and other physical problems. Addis had “significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movement or gait and station.”

“Significantly, there is no discussion of the records of Doctors Lavdas, McDonald, Gray, Files and McCarel, which he lists as having been submitted to him. Dr. Greenhood simply ignores them.”

Obama’s DOL Directors sent me letters from Washington and Atlanta with this quote :

“Please be assured that EBSA’s top priority is to protect the benefits of participants and to make sure that providers of those benefits obey the law.”

That was a year ago, and they have still done nothing. They won’t even ask Dr. Greenhood or the other doctors to stop endangering the lives of patients who may die during the years it takes their case to get to Court.

According to the Wall Street Journal, 15% of US adult males, 7% of boys,  26% of US adult females, and 5% of girls are on a psych drug and according to the National Criminal Justice Reference Service 6% of individuals over the age of 12 use illicit drugs. We have known for a long time that illegal drugs are deadly and we now know that psychotropic have horrible side effects including suicide ideation.

I would thus suggest that the worst drugs pushers are those mentioned in Ken Kramer’s website.

This is the website mentioned in the story: http://www.psychsearch.net

“ProPublica learned about the terminations of Mendez-Villamil and Merayo from Ken Kramer, a Florida Scientologist who runs a website devoted to exposing what he considers abusive practices by psychiatrists. Scientologists believe that the drugs used by psychiatrists “have no basis in science” and create “lifelong drug addicts,” according to the Church of Scientology website.”

I don’t think it’s useful to decry all drugs prescribed by mental health medical professionals just because some seem to have used overprescribing as a way to pad their own wallets.  Take away the ability for doctors to receive kickbacks from Big Pharma rather than the medicines.  All I know is, my teenager cannot function without his meds and functions excellently with them. 
Scientology is the quack here. At least mental health drugs can be peer reviewed, must have replicable test results, can have basic scientific review principles applied, etc. - none of which can happen in Scientology.

Hooray for Florida! This kind of housekeeping is long overdue and needs to be done in every single state. If psychiatry had no government subsidy they would be out of business. Some day we’re all going to look back and say “remember when we had psychiatry?” just like they say “remember when we had Nazis?” We just need to stand up as a nation and say NO!

Once again the government officials that are paid to oversee Medicaid and protect the public and our children against heathcare and psychiatric fraud and abuse have failed. This reminds me of the the Penn State child sexual abuse scandal now making news headlines. There just isn’t any accountability or real punishment for white collar criminals whether they are slick Wall Street bankers or unethical psychiatrists, doctors and healthcare providers who accept money from big drug companies. Notice how quickly drug companies Eli Lilly and AstraZenica distanced themselves from their low-life, paid spokesman, psychiatrist Mendez-Villamil once his actions were exposed. Thank goodness there are people like Iowa’s Senator Grassley and psychiatric abuse watchdog Ken Kramer around to expose this kind of psychiatric, medical and Medicaid abuse. Those Florida bureaucrats who were being paid to protect the public against all this should be in the unemployment line and have their state pensions terminated. This is just part of a larger trend of everyday Americans having to step in where their government has failed in its job to protect the public. Maybe that’s why we’re seeing so many movies about Super Heroes these days. Those paid to protect us aren’t doing their jobs and the public is clamoring for somebody to intervene, even if it’s only in the movies and in a few real-life cases like this. Watch now as the Florida Attorney General fails to grab the ball and fully investigate and prosecute this crime. This bad-apple psychiatrist is probably just the tip of the iceberg.

What a great article detailing the efforts of Senator Grassley and private citizen Ken Kramer to expose and put a stop to Medicaid fraud and highly unethical conduct by a Florida psychiatrist. And yet posted above is a comment by someone who wants to shoot the messenger by attacking Mr. Kramer’s religious beliefs and implying that somehow because he helped expose this criminal activity that it isn’t valid because he isn’t providing proof that his religious beliefs are valid. Is there anyone in the world that can prove that their religious beliefs are facts. That’s why they are called religious beliefs and not religious facts. In America we are free to have a wide variety of beliefs even though many of them seem odd, different or unproven. Imagine if every person reporting a crime or calling 911 was asked, “And before we act on your report sir, could you just tell us what your religious beliefs are and whether they have been “peer-reviewed and produce reliable results?” She implies this while admitting she gives her kid these drugs. Good luck with that. I doubt that many kids growing up on a diet of antipsychotics (the replacement for Thorazine) will ever be able to leave their parent’s care and function as responsible adults. More likely they are doomed to be life-long psychiatric patients on drugs and Medicaid that we all work to support. Let’s at least applaud any exposing of cases where these drugs are fraudulently, wrongly, and unnecessarily prescribed to anyone, not just kids.

While any drug can be abused, wrongly prescribed, overprescribed, and have side effects, psychiatric drugs seem to be especially subject to these problems. I think it’s because psychiatrists have so little to offer that creates any noticeable effect that they rush to offer drugs, which while they may not have a good effect, at least have a noticeable effect. Also, by their very nature as psychotropic drugs, they can put the mind as well as the body out of whack. Potential users of psychiatric drugs—read those black box warnings very carefully!

Well done to ProPublica, Senator Grassley and Scientologist Ken Kramer for their work in exposing this crime committed on the people of Florida—to endanger a patient’s life with drugs documented to cause weight gain, Diabetes and cardiac arrest, while getting kickbacks from drug companies for doing so.

These actions, although likely justified in individual cases, will make physicians disinclined to prescribe monitored medications, especially pain-killers. The federal government has on multiple occasions prosecuted individuals unfairly. After their names are scattered over the press and their reputations destroyed, no mention is made of their acquittals.It’s sad but true.

The detail about non-citizens stopping antipsychotics medications when they were exempted “from taking the U.S. citizenship test” doesn’t make sense. In the State of Florida, non-citizens do not qualify for Medicaid.

These guys don’t just prescribe one or two percent more than the next guy. Some of them are prescribing two, three and even four hundred percent more. It’s no wonder the Senate Finance Committee investigated this and contacted the U.S. Health & Human Services Office of Inspector General, alerting them to possible “overutilization” (excessive prescribing) of drugs covered under Medicaid.

Psychiatric drugs in particular are a huge, black joke perpetrated on an unwitting populace: The makers of the drugs don’t know how the drugs “work” and the psychiatric profession doesn’t even know what causes depression, schizophrenia, bipolar, etc.

C’mon, Earth: Get a clue.

Nice work, Ken Kramer of Florida.

Thank you, ProPublica for another great piece of journalism on a topic that affects EVERYONE, either directly or by association. And tip of the hat to Ken Kramer in Florida, too.

I am heartened by stories like this and the continuous inroads being made to expose the rampant fraud in the Psychiatric Drugging industry. In my experience there are two types of people with regard to Psychiatry. Those who have suffered its debilitating affects including the friends, family and caregivers that have suffered with the “drugged”, and those that have no personal experience other than what they read or are told and simply believe these are “doctors” giving “medicine” so it must be “treatment” and helpful.

I have yet to meet someone who hasn’t changed their mind about Psychiatry and Psyche drugs once they have experienced their horrors. I am personally now helping my sister in law get into a treatment center to detox and get off of 10 years of multiple Psyche drugs that have left her diabetic, mentally unstable (nearly psychotic) and close to ruin.

Mr. Kramer is a stalwart crusader for the truth. I commend him.

Harry Johnson Sr

Nov. 17, 2011, 4:49 p.m.

Hello other US Attorney Generals. This is going on in your states too. How about taking action for the purpose of protecting the many children and elderly being needlessly harmed by these drugs. You are in office to protect the public, not PhRMA and the mental health drug pushers.

Who gives a shit what a cult member thinks!My life has been dramatically improved by using psychiatric drugs over the past ten years.Before I had to use illegal street drugs to stabilize my depression.I have “severe, recurrent,major depressive disorder” and ” antisocial personality disorder”.Without my meds I would be in jail.You all should think twice before you pass judgement on this issue.Ken Kramer should get a life and seek help with his cult membership.

Hi Michael,

Thought I’d give you a list of medical doctors, Psychiatrists, Neurologists, etc who also agree with Mr. Kramer.

Thomas S. Szasz Professor of Psychiatry Emeritus at the State University of New York Health Science Center in Syracuse, New York

Dr. Fred Baughman, Neurologist

Dr. Julian Whitaker, M.D.

Dr. Colin Ross, Psychiatrist

Dr. Ron Leifer, Psychiatrist

Dr John Rengen Virapen 35 year Eli Lilly Scientist.

You can see hundreds more Medical Experts by watching a few documentaries online called “Marketing of Madness, Making a Killing and the latest DSM Psychiatry’s Deadliest Scam”.

I don’t believe anyone is passing judgement on you. But the fact that nearly 40,000 die from Psyche Meds each year, that Billions in Fraud are perpetrated by Psychiatrists each year, that the largest percentage of criminals, pedophiles, etc occur in the field of Psychiatry (all stats you can look up) make this an important issue for public discussion.

I hope you stay well.

Walter D. Shutter, Jr.

Nov. 17, 2011, 5:16 p.m.

Easy access to psychotropic drugs and painkillers thanks to a writing Croaker. Can’t beat that with a stick.  I should have retired to Florida.

“Scientologists believe that the drugs used by psychiatrists “have no basis in science” and create “lifelong drug addicts,” according to the Church of Scientology….”

And Scientology a “basis in science”  ???? !!!!

Talk about the pot calling the Marijuana green !

Thanks for writing this article! This issue has been around for a long time and with the belt-tightening going on with all levels of government I hope all areas of medicine are scrutinized carefully when public money is involved.

Autistic kids are the new target that psychiatry and big pharma have set their sights on using Medicaid money to pay for the drugs. A close friend works with a couple of autistic kids as part of her job. The parents of one kid refuse to drug him and although that kid has Autism, he is generally happy and able to function pretty much on his own in the Junior High School. The other Autistic kid has parents who have bought into putting their kid on psychiatric drugs. The kid is on the antidepressant Cymbalta and the antipsychotic Risperdal (not FDA approved to be given to kids 18 and under but millions of kids are on antipsychotics anyway). The medicated kid can barely function. He is constantly scratching his skin and agitated like he wants to “crawl out of his skin.” This is a dangerous “side effect” called Akathesia. Nobody seems to recognize it. The kid is fixated on drawing Swastikas all day long and has frequent emotional “meltdowns” where he has to be physically removed from the classroom until he cools down and gets it together. He freezes up during a fire drill and is incapable of evacuating himself from the building. It takes almost one full-time school employee to get this kid through his day. So, well beyond the crime and healthcare expense of psychiatrists over-prescribing antidepressants and antipsychotics, many people in society have to deal with these over-medicated people and see that they don’t harm themselves or others. What is going through a kid’s head that he draws Swastikas all day? The Black Box Warning on these drugs warns they can cause violent thoughts and actions. I sure hope his parents don’t have a gun. It takes a lot to speak up against this kind of criminal psychiatric abuse. Few people are up to it. Some are putting their jobs in jeopardy when they speak up. That’s why my hat is off to ProPublica, Senator Grassley and Ken Kramer.

Almost the entire practice of psychiatry today is fraud. From the diagnosis to treatment, it’s just plain fraud. I’m glad truth has won a small battle here in Florida. Now let’s see the whole house of cards come tumbling down.

Ron,I have seen Marketing of Madness.I agree that the drugs are grossly over priced.I have no medical insurance.My scripts cost me $2800.00 a month.I take three drugs.The price of two of them has gone up 400% in the last ten years.Many old school doctors have issues with type and amount of drugs my doctor has put me on.All I can say is that I took tens of different kinds of drugs before we found the right cocktail to manage my mental illness.I feel very lucky to have found a young progressive Doc. that has been able to make my life worth living.I am a firm believer in a better life through pharmacology.

The fact that doctors who see many different patients who are on Medicaid must be doing something right, like getting a good reputation. Or maybe their office is located in a good location for people on Medicaid, and do they really make more money since they don’t get a cut from the pharmacy? I should state that I have benefitted from an anti-depressive medication originally prescribed by a psychiatrist, but was then able to get the prescription from my Primary Care Physician until I eventually went off the medication when I got better. Why pick on a few doctors because they happen to see a lot of Medicaid patients? Especially ones who specialize in helping the patients who need psychiatrists? Okay, it doesn’t say Dr. Hernandez was a psychiatrist, he was barred from performing surgery because he was blind in one eye, so I doubt he was a psychiatrist. Be careful not to lump some doctors in with others and say ‘guilt by association’. Get some of their patients for an article like this for some quotes to support the argument.

It seems the people defending psych drugs can’t get anything straight.

No one seems to remember 20-30 years ago none of these were being dispensed.  We had no shootings in our schools, shopping malls and college campuses.  We didn’t have parents murdering their children, spouses and then taking their own lives.

These drugs are prescribed in the military to lower suicides and these have multiplied, not decreased.  The answer to this? “Imagine how many more suicides there would be with no ‘treatment’”.  Well I say let’s check that Bull——out.  Let’s remove the drugs from the treatment regimen, wean the troops who have been conned into taking them, off of them and then see if the suicides don’t fall back into the range they were before.

Also, 4.7 million clams for prescriptions isn’t just “over-prescribing”, it’s impossible if you do the math.  Check out Justice Department statistics—psychs comprise less than 5% of all doctors and commit over 20% of all medical fraud.

That would not be possible if they had a science.  There would not have to be fraud.  The “medications” would treat the illnesses, the symptoms would decrease, not increase.

But no, we have a couple people here shooting the messengers—Scientologists.

Don’t get me wrong, I’m a Scientologist and I say if you want your prozac, take as much as you want.  If it takes becoming a statistic and being so debilitated as to become useless to convince you that you made a mistake, so be it.  Don’t say no one warned you.

Now that message is from me personally, I’m sure all other Scientologists commenting here, when they see the above paragraph, the hair on the back of their necks will raise up.  My comments about people defending psych drugs and psych drugging aren’t in any Scientology materials.

RandyBluesmanHock

Nov. 17, 2011, 10:32 p.m.

These guys are “Legal Drug Pushers” No More No less!

Ignore every comment written by any scientologist. A scientologist is a person recruited by a destructive cult, and then conditioned to hate psychiatrists & psychologists. That hatred is part of scientology dogma. The rank-and-file scientologist does no thinking on his own; he merely parrots his group’s party line. Scientology, being a cult, needs an “over there enemy” to keep their members busy and not noticing the mental abuses being done all around them in their own group.

Thank you for a great article!  This is an important topic to shed light on.  And an additional hats off to those brave enough to speak up about it, like Ken Kramer.

Concerned Floridian

Nov. 17, 2011, 11:14 p.m.

This is a start but there is still MUCH to be done to combat the current situation that BigPharma has created here in FL.

I have attempted to find info concerning payouts from Big Pharma to our elected representatives…. Good luck!

How many children/young adults/adults have to DIE before we realize the amount of prescription drugs that are being handed out in FL?

I’d like to commend ProPublica, Weber & Ornstein,the authors of this article, Senator Grassley and Ken Kramer for investigating and exposing doctors who over-prescribe psychiatric medications and engage in other unethical practices.

I want to point out that there are going to be many cases where these drugs are extremely helpful to the patient.  I consider pharmaceutical psychiatry to be in the same boat as medicine was five hundred years ago, with “balance of four humours” being the basis.  Many treatments (bleeding) were destructive, but they had to start somewhere.

So I don’t believe the Scientologists have it right any more than an anti-doctor movement in Shakespeare’s time would have been right.

That said, the extremism of the Scientologist position makes them highly motivated and well-suited to locating and documenting abuse by doctors.  While I disagree with their philosophy on pretty much every level, I’m glad they’re doing the legwork.

(To pick another popular ProPublica topic, would you prefer a report on fracking compiled by oil executives or tree-hugging Hippies?  The establishment is more likely to conceal data, whereas you can adjust for the opposition’s bias when reading.  If you can’t, then go do your own independent research with your own biases.)

Personally (and this echoes Mike’s comment about the military suicides), I remember a time when Prozac was a rude punchline in jokes about school (and especially postal) shootings.  We heard incessantly about the horrors of these drugs.  Today, the problems haven’t gone away, but they no longer make headlines.

Good article….this is WHY we have such high costs in each State for Medicaid.  Each state needs to monitor it’s Medicaid program and find these problems BEFORE someone has to bring it to their attention.  It’s OUR taxpayer money that is paying for Medicaid, and they are NOT using it wisely.  And, cutting back in these departments (per the GOP & Tea Party Group) won’t solve the problem of the high cost of Medicaid to each state…..we need MORE investigators to find the fraudulence in Medicaid and do something about it other than a slap on the wrist!  Again, this is why the healthcare program will help to keep Big Pharma from making our kids into drug addicts!!  IMO only.

Thank you for exposing the real truths about the massive psych drugging across America.

Thanks for exposing the truth about psych drugging going on in Florida and what is being done to crack down on the offenders.

Re:  “Immigrants can qualify for citizenship without taking the test if they can prove they are physically or mentally disabled.”

That 2% of the 1980 Cuban Mariel “boatlift” who were rejected as “serious or violent” criminals missed a bet. lolll…but immigrants who aspire to become one of Wall Street’s “white collar” criminals are and always have been acceptable, of course.

Evelyn Pringle

Nov. 18, 2011, 9:49 p.m.

I think the article is right on and the outcome discussed is great but LONG OVERDUE. However, I don’t understand the purpose of identifying Ken Kramer’s religious beliefs. 

What are the religious beliefs of Senator Grassley or the staff members of ProPublica or the doctors mentioned in the article?

It almost seems like the religion of Scientology was inserted into the article for the sole purpose of drawing criticism and attacks on one specific religion.

I’m not a fan of any organized religion but I think people who find it necessary to bring up a person’s religion in published articles or internet blogs should be required to identify their own religious beliefs.

Finally, I think Ken Kramer should be given the credit he deserves for years of hard work exposing the drug pushing schemes in Florida without any mention of whether he’s a Scientologist, Catholic, Jew, Muslim or member of any other religion.

I think that the post of Jayna Lucas should be translated as follows: “I am unable to handle my own problematic child. I therefore find it useful to knock him out with drugs. I clearly side with anyone who can peddle out dope for that purpose. But rather than going to a street dealer, I turn to the dealers in w white coat. For one, it is legal. And secondly, I am glad to believe the official so-called scientific and medical papers because they allow me to silence my conscience and attack and criticise those who do not side with my point of view, even if I know full well that know little, if anything at all, about what I am criticising, and also about what I am supporting”. There! Like this is much clearer.

Bravo to this article.  I have lost a mother because of a psych drug.  Lost a sister to continued use of many psych drugs.  Oh yeah and before that she got diabetes from one of her drugs (the only one in a large family to get that disease).  I hope the word gets out more.  We need to stop the insanity - the insanity of pushing psych drugs all on people.

This article is very educational. Most people don’t know this information and take any drugs that any doctors recommend so it is really important that there is more article of the sort so that the public are able to make the proper decision regarding their health.
Thank you, thank you and again thank you for waking people up

Great article! Big Pharma is making millions hooking people on drugs, when there are far better ways to help people who suffer from depression, anxiety, etc.  These “ailments” are part of the human condition, they are not illnesses. Hooking people on drugs works in much the same way lap-band surgery does for overweight people. The problem is “solved” momentarily by a quick fix, only to rise again b/c the underlying cause was never addressed.

Thank you Pro Publica for exposing these poisoners.  Hopefully our laws will change and we can start to get rid of these scum…

Karen Kettner

Nov. 20, 2011, 9:31 p.m.

It’s about time some of these guys get nailed. Drug, drug, drug is not the way to help people.This is criminal. They should lose their license, be barred from the industry and spend some time maybe at the morgue where too many of these guys ended up andddddd pay back the state some of this money.

Frank Giramonti

Nov. 21, 2011, 2:34 p.m.

You do a terrible disservice to persons who suffer from schizophrenia when you causally mention “powerful antipsychotics” in the same breath with alleged wrong doing prescribers, stigma once again gets perpetuated. You need to separate wrong doing from what is a terrible disease that seldom gets the appropriate resources that it requires. This is yet another example of journalistic sensationalism.  There is a clear difference between first generation antipsychotics and second generation medications. Now that they are all going generic ( and are cheap), you probably won’t have that much to say about them.

It’s great to see that someone is looking for all the fraud in the system, so that normal people might have a chance to actually use one of the benefits we’ve worked all our lives for (before these thieves bankrupt the system.)

As far as people trying to dismiss this because Scientologists are the ones bringing it up—15 years ago members of this religion were screaming that Prozac caused suicides.  Today, the FDA’s black box warning on these type of drugs validates everything they were/are saying!

This article is part of an ongoing investigation:
Dollars for Doctors

Dollars for Doctors: How Industry Money Reaches Physicians

ProPublica is tracking the financial ties between doctors and medical companies.

The Story So Far

ProPublica is investigating the financial ties between the medical community and the drug and device industry. In October 2010, ProPublica compiled the list of payments that drug companies make to physicians and built a publicly searchable database so that patients could look up their doctors.

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