Doctors Prescribing Xanax

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Kicky Says:
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I have Medicaid & I'm under a lot of stress & need a dr to prescribe Xanax in the Dallas Texas area. They have to accept Medicaid as I have no insurance.



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Eddy Says:

Medicaid Rules are Wild. Xanax for Children!

Texas has a handful of physicians taking advantage of Medicaid rules by prescribing inappropriate medications for children. This is not only bad for the kids, but eats up Medicaid money that should go to other people. The problem was detailed in an editorial in the Fort Worth Star Telegram. Here are excerpts:

With little oversight and apparent carte blanche, a relative handful of Texas physicians wrote $47 million worth of Medicaid prescriptions for powerful antipsychotic and anti-anxiety drugs over the past two years, according to a Star-Telegram analysis.

The top five doctors alone wrote $18 million worth.

Most of the drugs have gone to children and adolescents, although prescribing the drugs to children, such as a toddler, is considered “off-label” — uses not approved by the federal Food and Drug Administration.

Now the state’s Medicaid program is among others under scrutiny, after Sen. Charles Grassley, R-Iowa, began investigating the use of mental-health drugs this year. Grassley, the ranking member of the Senate Finance Committee, told federal health officials to keep a better watch on top prescribers. His conclusion: Either some physicians have specialized expertise or the number of prescriptions suggests “overutilization or even health care fraud,” according to an October letter sent to the Health and Human Services Department.

Some advocates are concerned that the drugs are unsafe for children, who make up nearly 75 percent of Texas Medicaid’s 3.2 million recipients. In a 16-state study, Texas had the maximum rate of prescribing multiple mental-health drugs to youths in foster care. Although the number of prescriptions had dropped 19 percent by 2007, Texas was still tops, according to the June study.

And some doctors churn out prescriptions for children and others at an alarming rate. Antipsychotic drugs prescribed to children under 6 grew by 20 percent from 2007 to 2009, according to a November report by the Texas Health and Human Services Commission.

About 1.7 percent of children on Medicaid received antipsychotic drugs in fiscal 2009, state officials said.

Some children are overmedicated: One area doctor routinely prescribes five potent mental-health drugs simultaneously, said one of the state’s top prescribers. He said he tries to scale back the number of drugs the children are on.

Some experts believe that medication has pushed aside talk therapy, which might be effective and reduce medication needs.

The child, 31/2, suffers from shaken baby syndrome. When stressed, he pulls at his ventilator hoses and tracheotomy tube so much that his hands must be tied to the bed. He is prescribed antipsychotics because other sedatives could suppress the breathing centers of the brain.

Grassley asked Texas and other states for the top 10 prescribers who billed Medicaid for certain drugs. The Star-Telegram used prescriber numbers to identify the doctors, then sorted and tallied the drugs they were prescribing. Also reviewed was information on other mental-health drugs that have cost taxpayers about $1.3 billion during the past five years.

The analysis and research found:

In the past two years, 72 Medicaid providers wrote 186,992 prescriptions, an average of 2,597 each.

The state’s top prescriber, child psychiatrist G.K. Ravichandran of Houston’s Shamrock Psychiatric clinic wrote 27,000 scripts for the anti-anxiety drug Xanax in the past two years. The next-closest physician wrote 6,300.

Under his license, 44,138 prescriptions for antipsychotic drugs were written, at a cost to Medicaid of $6.4 million.

Dr. Fernando Siles, a child psychiatrist in Greenville, is the second most prolific Medicaid prescriber. He sees children from across North Texas, including Tarrant County.

In the past two years, Siles’ medical license was used to write 13,601 antipsychotic prescriptions at a cost of $4.6 million.

Siles, who treats solely Medicaid recipients, some as young as 3, has three nurse practitioners who also write prescriptions under his license, he said.

Many children referred to him are already on multiple antipsychotic drugs, and he tries to cut back, he said. “Fifty percent of the medications I prescribe, I did not start them on the medicine,” he said. “They came from other doctors.”

There may be other physicians who are also prescribing high volumes of antipsychotic drugs but aren’t as easily detected, state officials say.

Some physicians use a clinic to hide the volume of their prescribing, said Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, which oversees Medicaid.

“To be quite honest, we feel like single doctors have started to bill under clinics to maybe hide that, to make it look like it’s not a single doctor prescribing all these,” she said.

The 13-year-old girl suffered depression and post traumatic stress disorder. She cut her arms and stomach. Her stepfather molested her, and then beat her when she refused to have intercourse. She cannot sleep at night for the nightmares of being locked in a closet. Prescribed an antipsychotic off label, she begins to have fewer flashbacks and nightmares.

Another top prescriber, Dr. Adolphus Lewis of Fort Worth, is a family physician who also treats the elderly. In one year ending in 1994, he wrote 61 prescriptions for one male patient, including enough Vicodin and Valium to pop seven pills a day.

The state medical board accused Lewis of prescribing “medically excessive” numbers of pills to a woman who later died, court documents show. Her death, which was due to respiratory failure, implicated three drugs, including two that Lewis previously prescribed, according to the documents.

About 40 percent of the 72 top Medicaid prescribers among certain antipsychotic drugs have been disciplined by the state medical board. By comparison, last year the state disciplined less than 1 percent of the state’s 62,521 doctors.

In 2002, the Texas Medical Board restricted Ravichandran’s license for five years for “unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injury the public.” The restriction, which was not related to prescriptions, was lifted within three years.

Siles’ license is spotless.

Lewis was restricted in 1998 for failure to practice medicine in an acceptable manner because of his prescribing. From 2008 to 2009, he wrote 3,696 prescriptions for antipsychotics — roughly 10 each day — that cost taxpayers $1,395,595. Lewis’ license is connected with 10,000 prescriptions of mental-health drugs to 1,864 clients from 2005 to 2009, fifth most in the state among Medicaid providers.

The state has automated checks, called edits, to catch overuse, incorrect dosage and misuse, Goodman said.

Identifying even one inappropriate prescription is difficult, Goodman said.

“To really prove up a case, you have to prove some of those prescriptions were inappropriate. And it’s not just the volume alone that does that,” she said. “It’s really going in and looking at the patient’s records and getting another doctor to say, ‘That prescription was not appropriate in that case.’”


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Eddy Says:

Xanax and Medicaid in Texas should be no problem!

In the past two years, 72 Medicaid providers wrote 186,992 prescriptions, an average of 2,597 each.

The state’s top prescriber, child psychiatrist G.K. Ravichandran of Houston’s Shamrock Psychiatric clinic wrote 27,000 scripts for the anti-anxiety drug Xanax in the past two years. The next-closest physician wrote 6,300.

Under his license, 44,138 prescriptions for antipsychotic drugs were written, at a cost to Medicaid of $6.4 million.

Dr. Fernando Siles, a child psychiatrist in Greenville, is the second most prolific Medicaid prescriber. He sees children from across North Texas, including Tarrant County.

In the past two years, Siles’ medical license was used to write 13,601 antipsychotic prescriptions at a cost of $4.6 million.

Siles, who treats solely Medicaid recipients, some as young as 3, has three nurse practitioners who also write prescriptions under his license, he said.


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Verwon Says:

Hi, Kicky! How are you?

While it's possible to research doctors in your area, I really have no way of finding out what insurance they do or do not accept.

Do you currently have a GP that you see regularly?

If so, then it may be easiest to have them refer you to someone for treatment.

Learn more Xanax details here.

Since this medication can be habit forming and is commonly abused, most GPs won't prescribe it, but will refer you to another doctor that can help you with your problems.

Does anyone else have any ideas to add?



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Eddy Says:

Well yes Verwon. I never had a Doctor refuse to prescribe Xanax. A regular Doctor visit is $20 with my BCBS, yet the cost to see a Psychiatrist in my area is $500. If Texas has not changed their laws, it seems Xanax is very obtainable

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liz Says:
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Hi I was wondering if you ever found a good doctor in the dallas area that perscribes xanax that takes Medicaid?

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Seekhelp Says:

After 10 years of being disabled and being on Xanax for panic attacks, Texas Mutual Worker's Comp has told my doctor at Texas Back Institute in Plano, TX; that he can no longer treat me or 11 others that have the same W/C. I went to the new dr that they referred me to, who I've never heard of and she refuses to prescribe me 2 of the medications that I've been on since it was proven by a panel of doctor's and a judge that I need. 1 of them I'm willing to live without (dilaudid), but I can't go without the Xanax. Please help me find someone in my area who will prescribe me the medication I need before I loose my ever loving mind..

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BL Says:

The politicians in Washington demand knowing what states are doing to discipline top Medicaid Providers who of certain meds of abuse. Many state Medicaids have restrictions on the diagnosis codes they will pay for these meds under and often how many doses. Studies have shown that the majority of Medicaid Receipents have illegal drugs as well as drugs they weren't prescribed in their systems. Paying out of pocket for a private dr may or may not get you these meds after a while.

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humberto martinez Says:
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Im looking for a doctor that will prescribe xanax in Dallas, Tx. Preferably a family practioner, I pay out of pocket

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Erik Says:
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I have been on Xanax for 10 yrs. I have had a very traumatic life. From child abuse to the murder and rape of my 1st wife. Then my brother and sister dying horrible deaths. Not to mention all the other trials of life. I'm finding it harder and harder to cope with life. I also have panic attacks that are so bad I'm afraid of what I may do to others. I NEED HELP. Xanax is the only medication that levels me out to where I can feel normal and not feel like everything is closing in on me. How can I get a prescription?

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