A Chicago doctor who prescribed more of a powerful antipsychotic drug to Illinois Medicaid patients in one year than was prescribed to all Medicaid patients in Florida, North Carolina, and Texas combined will plead guilty to taking kickbacks from the maker of the drug, the Chicago Tribune reports.
Dr. Michael Reinstein had been known for several years for recommending massive amounts of the drug clozapine; a 2009 investigation by ProPublica and the Tribune had revealed the fact above about his prescription rate. From ProPublica:
Clozapine, also known as Clozaril and FazaClo, is approved to treat schizophrenia patients who don’t respond to other medications. But it can have dangerous side effects, including seizures, inflammation of the heart muscle, and a drop in white blood cells. The drug is considered particularly risky for elderly patients.
The U.S. government filed a civil suit against Reinstein in 2012 that charged him with taking kickbacks—and for submitting more than 140,000 fraudulent claims for payment to Medicare and Medicaid. He had a long history of dubious claims on that front, the Tribune writes:
A 1993 Tribune series highlighting problems in the Medicaid system showed that in 1991 alone Reinstein had billed for 15,480 patient encounters, mostly in Chicago-area nursing homes. He claimed in bills submitted to the system that he had cared for more than 70 patients a day on 44 different days, the newspaper found. The number of patients visits topped more than 100 a day on 12 days, his bills claimed.
The civil case against Reinstein, whose Illinois medical license was suspended in 2014, has not yet been resolved. He is expected to plead guilty on Feb. 13 to one felony count for a $2,000 kickback, though authorities believe he took far more than that sum overall. Teva Pharmaceuticals, the manufacturer of generic clozapine, paid $27.6 million to settle allegations it had bribed Reinstein but did not admit wrongdoing.
