![]() After repeated requests over the past month, neither he nor other state health officials could supply documentation on how many new enrollees had come into Medicaid or how many more had serious illnesses requiring controlled drugs. The state's Medicaid pharmacy manager, Jerry Wells, blamed "substantial increases" in the numbers of people on Medicaid for the rise in the number and costs of these prescriptions. State officials told the newspaper that they projected Medicaid would purchase 4.3 million of the high-strength pills, sometimes called Xanax by its brand name, this year. ![]() Use of these 2 mg alprazolam pills by the poor has more than doubled during the past three years, reaching more than 3.5 million doses dispensed for 2002, the analysis found. More than half his patients were on the highest dose marketed, 2 mg pills. Several pharmacies in Miami, for instance, dispensed the sedative alprazolam that a local doctor ordered for 2,000 low-income patients. The newspaper's analysis of Medicaid billing records, never before made public, revealed hundreds of similar excesses and detected explosive growth in dosage levels for a variety of compounds that are potentially dangerous but so inexpensive that regulators have not paid attention to them. That's about 8,500 pills, more than 20 a day over the course of a year, or at least seven times the standard dose. One person in the Gainesville area last year took home $62,000 worth of 80 mg Ox圜ontin pills, the highest dose of the painkiller marketed, according to the newspaper's analysis. Some pharmacies supply Medicaid patients with huge stocks of pills, sometimes at whopping dose levels. In total, Medicaid paid each of 84 Florida pharmacies $100,000 or more for filling narcotics orders that came from a single doctor. Six others received more than $500,000 each from the prescriptions of one doctor. Medicaid, for instance, paid three Florida pharmacies more than $1 million each for filling the prescriptions generated by a single doctor. Such profits can lower their incentive to blow the whistle on doctors. Many pharmacies earn substantial sums for supplying narcotics prescribed by only one or two physicians. The other said his name was forged on prescriptions.
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