DOCTOR FACES DRUG CHARGES

St. Lucie Authorities Investigate Prescriptions In 12 Deaths

A Port St. Lucie doctor whose offices were searched by law enforcement
officials in December was arrested Tuesday on charges of prescription drug
trafficking, racketeering and Medicaid fraud.

St. Lucie County sheriff's investigators led Dr. Asuncion Luyao, 60, out of
her 9474 S. U.S. 1 offices about 3:45 p.m.

Authorities later released state Health Department documents stating that
12 of Luyao's patients died from "drug intoxication or polydrug
intoxication" between December 2000 and November 2001.

"No one has concluded at this point that the deaths of her patients are
directly related to the medication that she was prescribing, but that's
certainly still a matter that's under investigation," State Attorney Bruce
Colton told a news conference.

Colton said records investigators confiscated from Luyao's office Tuesday
will be reviewed as part of that investigation.

"We're looking at all aspects, including the deaths, at this point, though
we are not concluding that she is guilty of any deaths," Colton said.

Luyao was held Tuesday night in the St. Lucie County jail on $2 million bail.

Meanwhile, the state Department of Health suspended the medical license of
Luyao, a 1965 graduate of the University of Santo Tomas in the Philippines.

"Nothing short of immediate suspension of Dr. Luyao's license will protect
the public from Dr. Luyao," Health Department records state. "Dr. Luyao has
abused the privilege of practicing medicine in the state."

According to the department's "Order of Emergency Suspension of License,"
Treasure Coast Medical Examiner Dr. Roger Mittleman initiated 12 complaints
with the department after performing autopsies on 12 of Luyao's patients.

"In each of his complaints, Dr. Mittleman opines that the combination of
medications prescribed by Dr. Luyao to each of the deceased patients caused
or contributed to their deaths," the order stated.

The investigation of Luyao became public Dec. 6 when a search warrant was
served at her offices in The Village Green shopping center after
investigators noticed a "tremendous amount" of prescriptions coming out of
her practice, Sheriff Ken Mascara has said.

"The basis of that search warrant was to obtain files patient files,
financial files, records, prescriptions and any evidence that can assist us
in an ongoing investigation with prescription fraud," Mascara said.

At the time, investigators found $63,000 in cash in a filing cabinet in her
office, and sheriff's Lt. David Thompson said the investigation concerned
whether Luyao overprescribed pain medications for "monetary gain," among
other reasons.

"She would take cash, not insurance. The reason for that is very simple,"
Thompson said.

"She wouldn't have to file a claim to Medicare or another insurance
company. She'd get her money up front. And a lot of these patients were
actually Medicare or Medicaid patients, so why would they, as a patient, go
pay cash to this doctor in lieu of going to another doctor that would take
their insurance?"

Thompson said several factors led to the charges against Luyao.

"Part of that would be how much medication is actually deemed necessary,"
he said. "Just as an example, if the average prescription would be four
pills a day for 30 days, total that number and then her prescription to a
patient may be 100 times that amount."

Luyao did not comment after her arrest, and her attorney, Barry Heisler,
was out of the state Tuesday and could not be reached for comment. In
December, he said he was unaware of any wrongdoing by his client.

"The medical records which were seized will prove that any prescriptions
provided by Dr. Luyao were medically based on the complaints of each
patient," he said at the time.

"I would be willing to bet that once everything is reviewed by medical
experts, you will find the care and treatment provided was reasonable."

But this month, Dr. Adam Greenberg, a board-certified physician in internal
medicine, reviewed 10 of Luyao's patient files at the request of the
sheriff's office. According to the sheriff's warrant affidavit, Greenberg
found:

- -- No patient visit notes are signed or initialed by the doctor.

- -- A liberal use of the combination of the controlled substances OxyContin
and Xanax.

- -- No objective documentation of any disease.

- -- Virtually no physical exam or history indicated in files to justify the
prescribing of these narcotics (OxyContin and Xanax). On Jan. 14, Dr. James
Buttles, who is on staff at Savannas Hospital, told an investigator that
he's treated "hundreds" of patients at the private psychiatric facility for
"prescription and drug dependency," sheriff's records show.

"Most of those patients were being treated by Dr. Luyao," the records state.

When told of the amounts of drugs including OxyContin, Xanax and Viagra
that Luyao prescribed an undercover investigator, Savannas Medical Director
Dr. Robert Cobiella said "that a person taking those medications would be
unable to get out of bed."

Steven Kogan, of the state Attorney General's Office, said Luyao "still
ranks about fourth or fifth in the state as a OxyContin writer."

According to sheriff's documents, the Medicaid records system shows
Medicaid paid more than $1.47 million from January 1999 to date for
prescriptions written by Luyao.

The number of Medicaid prescriptions written by Luyao for OxyContin jumped
from 151 in 1999 to 819 for the first 11 months in 2001.

Kogan said Luyao "never slowed down" after investigators served the
December search warrant.

"The majority of her prescriptions were for OxyContin," he said.