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Lincoln Star

By Mark Andersen
November 24, 2010

One Lincoln psychiatrist. Six mental health medications prescribed to Medicaid patients over two years. Cost to taxpayers: $2,927,872.

Newspapers around the country have picked up on the lists of Medicaid providers requested last April by Sen. Charles Grassley, R-Iowa, who suggested large numbers should spark official inquiries.

First, some cautions.

Medications for mental health can cost serious amounts of money. The consequences of not treating mental illness can be both tragic and expensive. And there\’s long been a shortage of psychiatrists in Nebraska, so some probably treat many patients.

In and of themselves, high prescription rates do not signal wrongdoing. But to a layman, the costs appear astounding.

In May, state Medicaid Director Vivianne Chaumont reported which Nebraska Medicaid providers wrote the most prescriptions for 11 types of medications during 2008 and 2009. Six of the drugs — Abilify, Seroquel, Zyprexa, Geodon, Risperdal and Risperidone — accounted for the bulk of the costs on Nebraska\’s lists.

Four Lincoln mental health providers were among the top 10 for those six drugs:

* Dr. Walter Duffy, a Lincoln psychiatrist, $2,927,872 (9,010 prescriptions), including more than $1.5 million for Abilify alone.

* Dr. Rafael Tatay, a Lincoln psychiatrist, $1,503,998 (3,998 prescriptions), including $473,700 for Abilify.

* Dr. Stephen Paden, a Lincoln psychiatrist, $587,917 (1,695 prescriptions), including $426,257 for Abilify.

* Dr. Pratap Pothuloori, a Lincoln psychiatrist, $545,487 (1,751 prescriptions), including $192,277 for Abilify.

In a letter to Health and Human Services Secretary Kathleen Sebelius, Grassley cited the example of a Florida doctor who wrote 96,685 prescriptions for mental health drugs in 21 months.

\”This trend is found again and again across the states,\” Grassley wrote, \”suggesting that top prescribers stand out not only against other providers in their state, but against the very top prescribers in those states.\”