AFR News: PsychSearch- Follow the Money and TERMINATE IT!

-------- Original Message --------

Subject:	Follow the Money and TERMINATE IT!
Date:	Thu, 18 Jul 2013 22:29:38 -0400
From:	PsychSearch <records@PsychSearch.net>
To:	<leonard@familyrights.us>

The background check on every American psychiatrist for discipline reports is winding down. You can see all the records we've compiled here: http://www.psychsearch.net/psychiatrists/ We just finished off Iowa, Massachusetts, and Michigan. We now only have 5 states left. Florida, Mississippi, North Carolina and Washington need a little work but recalcitrant Kentucky is another matter. The Kentucky Attorney General is handling this light work for us. You can read that chronology here: http://psychsearch.net/KentuckyAttorneyGeneral.pdf (might take a moment or two to open)

Thank you for your all your support and well wishes on the nationwide search for psychiatrist’s records!

The discipline reports are winding down, but new vistas of records now await us!

FOLLOW THE MONEY

Note: Two terms defined:

Medicaid: a government insurance program for persons of all ages whose income and resources are insufficient to pay for health care. It is jointly funded by state and federal governments.

Medicare: insurance for the elderly and people under age 65 with certain disabilities. It is funded at the federal level.

A whistleblower in Florida discovered that Miami psychiatrist, Fernando Mendez-Villamil, wrote approximately 153 prescriptions each and every day. This was reported to investigators in the office of U.S. Senator Grassley who then wrote a sharp letter demanding to know what federal agencies were doing to monitor such activity. Mendez-Villamil wrote $43 million worth of psych drugs between 2004 – 2009! News of Mendez-Villamil prescribing went national. The Florida Agency for Health Care Administration then terminated Mendez-Villamil's Medicaid privileges.

Grassley then commenced an investigation of top psych prescribers across the country. In 2010, he asked each state to identify the top 10 prescribers of certain psychiatric drugs between 2008 and 2009. In 2012, Grassley again requested each state to provide the same information for 2010 and 2011.

PsychSearch.net then contacted each state and obtained the records they sent Grassley. So, we have in our possession the names and the prescribing data of America's top prescribers of psychiatric drugs from 2008-2011. See here: http://www.psychsearch.net/top-prescribers/

OUR NEXT VENTURE

Part One

Investigate each of the top prescribers to find which ones have been terminated by Medicaid and as a result we will find the dollar amount no longer being spent on them. In other words, we intend to find the amount of Medicaid tax payer dollars spent to pay for prescriptions written by these psychiatrists who had their Medicaid terminated. Therefore, we will have an estimate of how much money was terminated. This will most certainly be in the millions because Fernando Mendez-Villamil alone prescribed about $4.7 million in antipsychotics in 2009.

Part Two

The federal government has a website where terminated Medicaid and Medicare providers can be looked up. Here's the link: http://exclusions.oig.hhs.gov/

Astonishingly, we discovered that Fernando Mendez-Villamil could not be found! What the ...? So that means Florida Medicaid stopped paying for drugs prescribed by Mendez-Villamil, but the Feds through Medicare are still shoveling tax dollars to him!

On June 19, 2013 PsychSearch.net started asking the feds why Fernando Mendez-Villamil was not included on their list of terminated providers. (you can see that string of emails - far below)

On June 20, 2013 we were informed by an Investigations Analyst at Health and Human Services: "We are investigating and will get back to you." But we haven't heard from them since!

On June 24, 2013 U.S. Senator Grassley sent a letter to each state in the country asking them, amongst other things, if they report their Medicaid terminations to the feds and also to provide the names of their last 10 terminations from Medicaid. You can see one of the letters here: http://psychsearch.net/grassley-letter-to-medicaid-programs.pdf In the letter, Grassley mentions two Miami psychiatrists. One, who wrote 96,000 prescriptions over 21 months (Mendez-Villamil) and without naming him, Enrique Casuso. He also mentions (again without naming him) prolific Chicago prescribing psychiatrist Michael Reinstein.

Today, July 18, 2013, we asked each State's Medicaid Director to provide a copy of what they gave Grassley. (then we’ll be able to find more psychiatrists who have had their Medicaid terminated)

So, folks, in an nutshell, we have the top prescribers in the entire country identified. We are investigating to find out how many of them were terminated from Medicaid after press hit nationally. We are adding up all the money that was terminated.

Then we are going to report these state Medicaid terminations and their prescribing in dollars to federal authorities because there is a breakdown in communication between states and the Feds.

Perhaps then Medicare will also terminate the flow of government funds as Medicaid did.

So, we're following the money.

This PsychSearch train is heading down the track and it won't be derailed.

How fast it moves depends on whether you give it a push or not!

You can push here:

++++++++++++++++++++++++++

Federal Inquiry (string of emails) mentioned above. Start from the bottom

From: Ken Kramer
Sent: Wednesday, July 17, 2013 9:01 PM
To: 'Joann.Francis@oig.hhs.gov'
Subject: RE: Re Exclusions

Hello Joann?

From: Ken Kramer
Sent: Sunday, July 14, 2013 6:56 AM
To: 'Joann.Francis@oig.hhs.gov'
Subject: Re Exclusions

Hello Joann,

What did you find out about states terminating providers from Medicaid who

then do not show up as excluded on your website http://oig.hhs.gov/faqs/exclusions-faq.asp ?

Sincerely,

Ken Kramer

From: Francis, Joann M (OIG/OI) On Behalf Of Sanction
Sent: Thursday, June 20, 2013 9:24 AM
To: Ken Kramer
Subject: RE: Exclusions

Yes, I did receive this email. We are investigating and will get back to you.

Joann M. Francis

Investigations Analyst

HHS, OIG, OI

Exclusions Staff

(202) 205-4193 (Office)

(202) 691-2298 (Fax)

This E-mail may contain sensitive law enforcement and/or privileged information. If you are not the intended recipient (or have received this E-mail in error) please notify the sender immediately and destroy this E-mail. Any unauthorized copying, disclosure or distribution of the material in this E-mail is strictly forbidden.

From: Ken Kramer

Sent: Wednesday, June 19, 2013 4:37 PM
To: Sanction
Subject: RE: Exclusions

Get this Joann?

From: Ken Kramer
Sent: Wednesday, June 19, 2013 2:00 PM
To: 'Sanction'
Subject: RE: Exclusions

Hi Joann,

I have seen in Florida where providers are terminated "without cause".

They had a contract with Florida Medicaid that includes that they can be terminated without cause.

Example - Florida psychiatrist Fernando Mendez-Villamil does not show up on your list but it has been widely

reported in the press http://www.propublica.org/article/florida-sanctions-top-medicaid-prescribers-but-only-after-a-shove

and in public records http://www.psychsearch.net/mendez-villamil/medicaid_termination.pdf that his Medicaid privileges have

been terminated. But he doesn't show up on your website: http://exclusions.oig.hhs.gov/?

So, you're saying that states can terminate providers from Medicaid and they won't show up as excluded on your website?

I'm just trying to determine what your list of excluded has and what it doesn't have.

Seems odd that one of the most notorious terminated Medicaid providers is not on your list.

From the story link above:

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.

Best,

Ken Kramer

From: Francis, Joann M (OIG/OI) On Behalf Of Sanction
Sent: Wednesday, June 19, 2013 1:42 PM
To: Ken Kramer
Subject: RE: Exclusions

I don’t understand what you mean by “without cause” termination….

State Medicaid agencies have their own websites, as well as their own actions. They may exclude someone that the OIG does not excluded.

Joann M. Francis

Investigations Analyst

HHS, OIG, OI

Exclusions Staff

(202) 205-4193 (Office)

(202) 691-2298 (Fax)

From: Ken Kramer
Sent: Wednesday, June 19, 2013 1:35 PM
To: Sanction
Subject: Exclusions

Dear Sir,

On your website http://oig.hhs.gov/faqs/exclusions-faq.asp it says:

What is the List of Excluded Individuals/Entities (LEIE)?

OIG’s List of Excluded Individuals/Entities (LEIE) provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid and all other Federal health care programs. Individuals and entities who have been reinstated are removed from the LEIE.

I know what I've come up with is pretty light compared to what I expected.

"Without cause" terminations could be the reason if they are excluded from your exclusions list seems "without cause" should also be showing up.

Are there state lookups for each state on what is missing from your database?

Best,