Federal authorities have charged a Chicago doctor with taking kickbacks.
Federal authorities filed suit against Dr. Michael J. Reinstein, a Chicago psychiatrist, on November 15, alleging that in exchange for kickbacks from drug companies, he prescribed a potentially dangerous psychotropic drug to thousands of Chicago-area nursing home patients with mental illnesses.
In a statement, acting U.S. Attorney Gary Shapiro said the lawsuit is “the largest civil case alleging prescription medication fraud against an individual ever brought in Chicago.”
In a 2009 joint investigation, the Chicago Tribune and ProPublica found that Reinstein relied very heavily on clozapine, a risky and powerful psychotropic drug. In 2007, Reinstein prescribed the medicine more than all the doctors in Texas combined, according to the investigation.
The lawsuit, filed recently in U.S. District Court in Chicago, alleges that Reinstein made no less than 140,000 false Medicare and Medicaid claims for antipsychotic drugs he had prescribed based on kickbacks from the manufacturers of the drugs, without regard to his patients’ needs.
Authorities further allege that he submitted at least 50,000 Medicare and Medicaid claims falsely stating that he had monitored his patients at Chicago-area nursing homes and long-term care facilities.
Authorities are seeking triple damages under the False Claims Act, in addition to civil penalties for every alleged false claim. The total damages could quickly reach seven or even eight figures.
Novartis, the maker of Clozaril, a brand name for clozapine, had a longstanding agreement with Reinstein to pay him to promote the drug, according to authorities.
The lawsuit described Clozaril as a “drug of last resort” and claims that despite this fact Reinstein routinely had thousands of patients taking clozapine at any given time.
In 1998, the patent on Clozaril expired, and generic versions of clozapine hit the market. But Reinstein “resisted pharmacy and drug company efforts to switch his patients to generic clozapine and continued to be the largest prescriber of Novartis’s Clozaril to Medicaid recipients in the United States,” according to the lawsuit.
In the summer of 2003, Novartis stopped paying Reinstein to promote Clozaril. At that time, Florida-based IVAX Pharmaceuticals Inc. tried to persuade Reinstein to switch to the firm’s generic form of clozapine.
Reinstein agreed, and for the next several years, IVAX paid him $50,000 per year under a “consulting agreement,” the suit alleged.
“After reaching this kickback agreement with IVAX, Reinstein immediately began switching his patients from Clozaril to IVAX’s clozapine,” the suit said. He soon became “the largest prescriber of generic clozapine in the United States.”
The lawsuit alleged that IVAX and its eventual parent company, Teva Pharmaceutical Industries, paid for at least three trips to Miami for Reinstein and several associates, including hotel, airfare, cruises, and dinners.
After the 2009 publication of the Tribune-ProPublica investigation into Reinstein, he told Teva to stop paying him, the suit says.
A spokeswoman for Teva released a statement saying the company was cooperating with investigators.
Paul Greenberg is a Chicago medical malpractice lawyer and Chicago medical malpractice attorney with Briskman Briskman & Greenberg. To learn more call 1.877.595.4878 or visit http://www.briskmanandbriskman.com/.