A Chicago psychiatrist faces $2 billion in penalties after the United States filed a civil health care fraud lawsuit against him Thursday, claiming he took kickbacks from drug companies and submitted at least 140,000 false Medicare and Medicaid claims for antipsychotic medications he prescribed to thousands of mentally ill patients in area nursing homes.
Michael J. Reinstein, 69, of Skokie is also accused of submitting at least 50,000 Medicare and Medicaid claims falsely stating he provided “pharmacologic management” for his patients at more than 30 area nursing homes and long-term care facilities.[…]
The alleged fraud began when Florida-based IVAX Pharmaceuticals began encouraging Reinstein to switch his psychiatric patients using Clozaril — the trade name for the drug clozapine manufactured by Novartis to treat symptoms of schizophrenia — to IVAX’s generic form of the drug.
Reinstein refused until August 2003, according to the lawsuit, when Novartis told him it would be withdrawing its “support” to him for Clozaril. Reinstein agreed to switch his patients to the generic IVAX drug if the company agreed to pay him $50,000 under a one-year “consulting agreement,” pay his nurse to speak about the drug, and fund a clozapine research study by Uptown Research Institute, with which he was affiliated.
Suddenly Reinstein became the largest prescriber of generic clozapine in the United States, according to the government.
From a patient review of Dr. Reinstein posted two years ago:
He has a conveyer type practice I completely believe that he prescribed medications more than all docs in three states google his name – approximately for 2-3 hours he saw 50 patients.So the conclusion is that this is the doc for middle/low-class but obviously organized well and satisfies its segment on the market. So if you can keep crazy environment and do not vomit from different aromas – probably you will be satisfied there is no other place in the city where the price of the 1st visit is 80$.
Are the feds sure about all of those fraudulent claims–190,000–or are they just throwing everything they can at Reinstein to make an example of him? Perhaps they aren’t being all that careful about distinguishing between legitimate and fraudulent claims.
I see now that
relationship with a drugmaker has drawn some attention in the past. From the Chicago Tribune, in 2009:
Executives inside pharmaceutical giant AstraZeneca faced a high-stakes dilemma. On one hand, Chicago psychiatrist Dr. Michael Reinstein was bringing the company a small fortune in sales and was conducting research that made one of its most promising drugs look spectacular. On the other, some worried that his research findings might be too good to be true.
As Reinstein grew irritated with what he perceived as the company’s slights, a top executive outlined the scenario in an e-mail to colleagues. “If he is in fact worth half a billion dollars to (AstraZeneca),” the company’s U.S. sales chief wrote in 2001, “we need to put him in a different category.” To avoid scaring Reinstein away, he said, the firm should answer “his every query and satisfy any of his quirky behaviors.”
Putting aside its concerns, AstraZeneca would continue its relationship with Reinstein, paying him $490,000 over a decade to travel the nation promoting its best-selling antipsychotic drug, Seroquel. In return, Reinstein provided the company a vast customer base: thousands of mentally ill residents in Chicago-area nursing homes.
And questions have been raised about the quality of care he was providing patients.
During that period, Reinstein also faced accusations that he overmedicated and neglected patients who took a variety of drugs. But his research and promotional work went on, including studies and presentations examining many of the antipsychotics he prescribed on his daily rounds.