A Miami psychiatrist who made national news for writing prescriptions for Medicaid patients at a rate of 150 a day, seven days a week, received what one U.S. senator called a “slap on the wrist” from Florida’s Board of Medicine during a disciplinary hearing this month.
Fernando Mendez-Villamil remains a licensed physician practicing psychiatry in his Coral Way office despite findings by the Florida Department of Health that he inappropriately prescribed medications at an inordinate rate and failed to meet professional standards, such as keeping concise patient records and performing necessary tests.
Mendez-Villamil, whose prescribing patterns came to light during congressional talks on the overuse of healthcare, declined comment through his attorney, Michael Gennett of Miami. But on Oct. 4, he accepted a settlement in which he admitted no wrongdoing but received a reprimand from the state Board of Medicine and a fine of $15,000.
Mendez-Villamil, 46, also agreed to pay the state up to $22,228 for costs of the investigation, and he will complete a course in “quality medical record keeping.” The agreement also requires Mendez-Villamil to hire a risk manager by mid-December to review his practice.
Sen. Charles Grassley, R-Iowa — who first brought attention to the huge numbers of prescriptions written by Mendez-Villamil — issued a statement Friday indicating that he felt the state medical board’s punishment would fail to deter future abuses of taxpayer-funded healthcare programs such as Medicaid.
“The state medical board reacted with a slap on the wrist,” Grassley said of Mendez-Villamil’s settlement agreement. “It’s hard to see how the state medical board could justify such a weak punishment. This raises concerns that over-prescription will continue to harm patients and taxpayers.”
According to state records, Mendez-Villamil was the top prescriber in the Medicaid program from late 2007 through early 2009, writing a total of 96,685 prescriptions — about 43,000 more than the second-highest Medicaid prescriber in the state for the same period.
Mendez-Villamil was terminated from Florida’s Medicaid program on June 21, 2010, said Shelisha Coleman, a spokeswoman for the state’s Agency for Health Care Administration (AHCA).
Coleman said Medicaid suspended all payments on his prescriptions after July 31, 2010, and that he remains ineligible for the program.
Mendez-Villamil sued AHCA in 2010 to have his Medicaid contract reinstated, but he asked to have the case closed in February and Leon County Circuit Court Judge Charles A. Francis dismissed the lawsuit in March.
The state’s investigation into Mendez-Villamil focused on three of his patients — including one who was age 3 when he began treatment — who received prescriptions for antipsychotics, amphetamines, anti-depressants and other drugs, including Xanax, Valium and Zoloft.
State investigators found that Mendez-Villamil did not refer patients or document referrals to specialists for evaluations of other potential conditions, nor did he substantiate or document his own diagnoses for conditions such as attention deficit hyperactivity disorder and other ailments.
In one instance, Mendez-Villamil prescribed a boy identified only as “Patient AT” a drug for impulsivity and, according to state records, wrote in documents that the boy, who was 5 at the time, was “able to take care of himself.’’