Two months ago, a small number of doctors in Florida received an unsigned letter from CVS/pharmacy informing them that the company's pharmacists would no longer fill prescriptions they write for painkillers and other powerful, addictive drugs.
The letter, which some have referred to as a "blacklist," has been criticized as discriminatory, and at least one Orlando doctor is firing back with legal action, claiming CVS has essentially pegged him as a criminal.
But CVS is also being praised for taking the measure at a time when prescription-drug abuse has reached epidemic proportions in Florida.
The company, which has more than 700 stores in Florida, refused to answer any specific questions about why or how it compiled the list, which includes at least 22 physicians from Central Florida. The company also won't say how many doctors statewide were notified that their prescriptions would no longer be filled.
"We have informed a small number of Florida physicians that CVS/pharmacy will no longer fill the prescriptions they write for Schedule II narcotics," CVS spokesman Mike DeAngelis said in an emailed statement.
"While we regret any inconvenience this may cause for our customers, we treat the dispensing of controlled substances with the utmost care and seriousness. CVS/pharmacy is unwavering in its compliance and measures to prevent drug abuse and keep controlled substances out of the wrong hands."
For years, prescription-drug abusers and dealers flocked to Florida because there was little to no legislation and regulation of pain clinics, and no shortage of rogue doctors willing to prescribe the pills.
In 2010, 90 of the top 100 oxycodone-purchasing doctors in the nation were from Florida.
Law enforcement responded to the epidemic by targeting drug rings - individuals or groups who buy hundreds of pills at pain clinics for sale on the street - and the doctors who supply to them. Lawmakers enacted legislation in July that toughens penalties against doctors and banned most physicians from dispensing drugs such as painkillers from their offices.
But this is the first time a major pharmacy chain is taking such an action - at least publicly - and it's unclear what impact it will have.
Industry experts say they can't recall another instance in which a pharmacy chain refused to fill a group of doctors' Schedule II prescriptions.
So what's the motive behind such a measure? CVS won't say.
Though the spreadsheet of doctors is titled "CVS-DEA: Florida High Prescribers," a spokesman with the U.S. Drug Enforcement Administration said his agency didn't have anything to do with the pharmacy's list, which the Orlando Sentinel obtained.
Critics of CVS, such as Orlando attorney Gus Benitez, say the pharmacy chain should be interested in making a profit - not cutting sales by limiting prescriptions for drugs such as oxycodone.
Benitez filed suit against CVS in December on behalf of one doctor on the list, Sylvester Hanna, who owns Wellness Centers USA, a pain clinic on Colonial Drive.
"When you take this action - when CVS takes this action - they're blacklisting these doctors, and they're casting this net where they're affecting a lot of people," Benitez said.
The defamation suit claims that by telling its pharmacists to refuse to fill Hanna's prescriptions, CVS is falsely implying that the physician is acting unethically or illegally.
Benitez said Hanna was "totally shocked" when he received the letter.
"It's emotionally affected him," Benitez said. "He's really, really upset that this is being done to him."
Benitez noted Hanna hasn't been arrested and said his medical office has a system of checks and balances to weed out patients who don't truly need pain medication.
Some known to cops
Many doctors on the CVS list are not strangers to law enforcement.
Five of the Orlando-area physicians who appear on the list have been arrested for prescription-drug- or medical-practice-related crimes. None of those cases has been resolved; all are still active in the courts.
- Mladen Antolic is accused of running a pill mill and hosting wild sex and drug parties at his Hunter's Creek home with women who he treated at his Orlando practice. He faces more than a dozen charges, including trafficking in a controlled substance and racketeering.
- Ralph Chambers is accused of dispensing virtually unlimited amounts of pills to patients who asked for drugs at his Sanford and Orange City offices. He faces charges of Medicaid fraud and conspiracy to commit trafficking in illegal drugs.
- Ronald Lynch was banned from prescribing controlled substances, yet he continued to write prescriptions for the drugs, the Department of Health said. He was arrested in November on more than 50 Medicaid fraud and drug-trafficking charges.
- Michael Moyer is accused of prescribing painkillers and muscle relaxers without valid medical reasons from his Winter Park office. He faces a variety of charges, ranging from trafficking of a controlled substance to marijuana trafficking.
- Vincent Scolaro was sentenced to jail and probation in 1999 for illegally obtaining or attempting to obtain a controlled substance in Volusia County. He was recently arrested again after investigators said he was illegally operating a pain clinic in Seminole County.
Orlando defense attorney Mark NeJame, whose firm NeJame Law represents several of the physicians on the list in their criminal matters, said CVS has created "an injustice for the many very good doctors out there who have clients with true pain issues."
The Florida Department of Health has recommended several of the doctors on the CVS list have their medical licenses suspended or revoked because of improper practices.
One of those doctors is Riyaz Jummani, who ran the Pro Relief Center and Pain Relief Center in Orange County until Department of Health and Metropolitan Bureau of Investigation officials raided both offices in June.
Agents with the MBI said Jummani prescribed more oxycodone in the final quarter of 2010 than all doctors in California during the same time.
The Florida Department of Health suspended Jummani's license. The criminal investigation into Jummani's practices is ongoing, said Florida Department of Law Enforcement Agent Tom Foy.
Other doctors on the CVS list are under investigation by law enforcement but haven't been arrested, law-enforcement sources say. The Orlando Sentinel is not naming those doctors because no formal action has been taken.
Community members outspoken against so-called pill mills and overprescribing doctors are praising the CVS action.
"I think it's a great idea," said Janet Colbert, a founding member of the STOPP Now (Stop the Organized Pill Pushers) organization. "I think that probably they're aware that now something is being done about this. People are dying. They don't want to be caught in that trap."