Psychiatrist Suspended for Antipsychotic Overprescribing

Pam Harrison

August 12, 2014

The medical license of Illinois-based psychiatrist Michael J. Reinstein, MD, has been suspended indefinitely by state regulators for prescribing irregularities, notably, fraudulent overprescription of the antipsychotic clozapine, ProPublica's Charles Ornstein reports.

The state of Illinois has the authority to permanently revoke a physician's license but usually does so only if a physician has been convicted of a sex crime or an assault on a patient. Dr. Reinstein had been practicing in the Chicago area since 1973.

The state's medical disciplinary board recommended the suspension of Dr. Reinstein's medical license in May of this year after determining that the Illinois psychiatrist had received "illegal direct and indirect remuneration" from makers of clozapine.

The disciplinary board also accused Dr. Reinstein of not considering alternative treatments for his patients and of disregarding his patients' well-being. Clozapine has well-established side effects, including seizures.

As reported by ProPublica and the Chicago Tribune in 2009, Dr. Reinstein had prescribed more clozapine to patients in the Illinois Medicaid program in 2007 than all doctors in the Medicaid programs of Texas, Florida, and North Carolina combined.

At least 3 patients under the psychiatrist's care had died of clozapine intoxication at that time. Dr. Reinstein reportedly defended his use of the drug, arguing that it is effective and underprescribed.

In 2013, ProPublica reported that Dr. Reinstein had prescribed even more clozapine under Medicare's prescription drug program for seniors and the disabled.

The program apparently continued to let Dr. Reinstein prescribe the drug even after the US Department of Justice accused him of fraud and the Illinois Medicaid program suspended payments to him.

A federal fraud lawsuit against the Illinois psychiatrist is currently pending in the US District Court in Chicago.

Prosecutors allege that Dr. Reinstein's long-term pattern of prescribing clozapine was motivated by money and perks from pharmaceutical companies.

As previously reported at the time by Medscape Medical News, Dr. Reinstein was accused of submitting at least 140,000 false claims to Medicare and Medicaid for clozapine prescriptions that involved illegal kickbacks from a string of manufacturers of the drug.

According to the complaint, Dr. Reinstein based his prescriptions to mentally ill patients not on evaluations and assessments of their psychiatric needs but in exchange for compensation agreements, first with Novartis and then with IVAX Pharmaceuticals as well as Teva Pharmaceuticals.

In March of this year, Teva Pharmaceutical Industries Ltd, which makes generic clozapine, agreed to pay over $27.6 million to settle state and federal allegations that they induced Dr. Reinstein to prescribe their drug.

ProPublica Inc. Published online August 11, 2014. Full text


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