STATE SENATORS URGE TOUGH PENALTIES FOR MEDICAID DRUG FRAUD

TALLAHASSEE -- A Senate panel set up to crack down on Medicaid fraud on
Tuesday demanded tough new laws to give health officials the power to
swiftly discipline doctors who prescribe grossly excessive amounts of
narcotics for the poor.

"These people aren't practicing medicine, they're practicing crime," said
Sen. Mike Fasano, R-New Port Richey, one of three legislators who sit on a
select subcommittee investigating prescription drug abuse in the state's
$12 billion Medicaid program.

"I'm in the brokerage business, and when someone breaks the law, they lose
their license."

Panel members cited the case of Dr. Armando Angulo, who over the past six
years prescribed more than $6.5 million worth of powerful drugs for
Medicaid patients, some filled after they were dead. Earlier this week,
state health officials ordered the former Hialeah general practitioner to
quit prescribing abusable drugs, but he retains his license. Angulo is
thought to be out of the country.

"He can still treat patients, but he just can't prescribe pain medication,"
Fasano said, "It's just baffling to me."

Outrage over the handling of Angulo's case dominated the panel's final
public hearing, but the senators also took testimony from state health and
law enforcement agencies calling for more staff, money and stricter laws to
curb abuses in the health care program for low-income and disabled Floridians.

The panel was set up in response to a South Florida Sun-Sentinel series
titled "Drugging the Poor," which found that less than 3 percent of the
state's medical professionals prescribed more than two-thirds of the
narcotics and other dangerous drugs dispensed to Medicaid patients. These
drugs cost taxpayers more than $346 million over the past three years,
helped feed an illegal street market for pills and contributed to fatal
overdoses.

"Everyone recognizes that this is not only costing the state millions of
dollars a year, but the lives of people are being destroyed. People are
suffering, and we need to bring it to a head," said Senate Health Care
Chairman Burt Saunders, R-Naples, who appointed and is chairman of the
three-member Select Subcommittee on Medicaid Prescription Drug
Over-Prescribing.

Among the reform proposals under consideration:

Legislation Florida Attorney General Charlie Crist supports to require that
any doctor who treats the poor be a certified Medicaid provider. The idea
is to crack down on doctors such as Angulo, who was kicked out of the
Medicaid program in December 2000, but whose patients, under a loophole in
the law, continued billing Medicaid for prescriptions.

Crist also wants to make it a felony for any Medicaid patient to sell
medications on the street and for any person to purchase these drugs
illegally or encourage others to sell drugs prescribed to them.

The Florida Department of Health wants new powers to begin investigations
of doctors who engage in a "practice pattern which demonstrates a lack of
reasonable skill and safety to patients." Under current law, the state
investigates each complaint it receives against a doctor individually. This
can drag on for years and seldom uncovers a pattern of substandard medicine.

The Florida Department of Law Enforcement plans to set up regional task
forces on prescription drug abuse, similar to the groups formed to battle
domestic terrorism after Sept. 11, 2001.

The select subcommittee is expected to complete a final report next month
and recommend legislative proposals for enactment in the upcoming session.

But much emotion at Tuesday's hearing focused on frustration with the
state's system for weeding out bad doctors.

A bill Saunders' committee is to hear later this month calls for the
immediate suspension of any doctor arrested on charges of Medicaid fraud
from participating in the program. Representatives of the state Board of
Medicine and the Florida Medical Association quickly endorsed that idea.

Dr. Lisa Tucker, chairwoman of the state Board of Medicine, which
disciplines doctors, said the board hopes legislators will let it block the
licensing of any doctor who has overprescribed in another state and let the
state set up a database that can identify patients who are getting multiple
narcotic prescriptions from either one or many physicians.