Dr. Michael Reinstein, right, leaves the Dirksen U.S. Courthouse on March 11, 2016, after being sentenced to nine months in prison for accepting almost $600,000 in kickbacks to prescribe a risky antipsychotic drug to thousands of patients in Chicago nursing homes and mental health clinics. (Phil Velasquez / Chicago Tribune)

BY: Jason Meisner – Contact Reporter – Chicago Tribune

A Chicago doctor who was once the nation’s most prolific prescriber of the risky antipsychotic drug clozapine was sentenced to nine months in prison Friday for taking cash, vacation trips and other kickbacks from the drug’s manufacturers.

Dr. Michael Reinstein, the subject of a 2009 Tribune-ProPublica joint investigation, admitted to pocketing nearly $600,000 in benefits over the years for prescribing various forms of clozapine, known as a risky drug of last resort, to hundreds of mentally ill patients in his care.

In rejecting calls by defense lawyers for probation, U.S. District Judge Sharon Johnson Coleman noted that like so many other doctors convicted of fraud schemes, Reinstein served a largely underprivileged group of people who are unable to fend for themselves.

The judge also said that regardless of whether he thought the drug was helping his patients, Reinstein violated the sacred doctor-patient trust by accepting the cash.

“That is the biggest danger here,” Coleman said. “It leaves a cloud over the patients and their families over whether they were put at some unnecessary risk. All of those questions are in their heads. … When money is inserted into the equation, there is no trust.”

When he pleaded guilty last year, Reinstein also settled a massive civil lawsuit brought by the U.S. attorney’s office alleging that he submitted more than 140,000 false Medicare and Medicaid claims as part of the kickback scheme. He was ordered to pay more than $3.7 million in penalties to the U.S. government and the state of Illinois.
chi-reinstein-kickback-plea-20150213In addition to the prison time, Coleman ordered Reinstein to forfeit an additional $592,000 and serve 120 hours of community service when he’s released from custody.

Reinstein, 72, of Skokie, showed no reaction to the sentence. Moments earlier, he had stood in the courtroom and apologized for his crime and the embarrassment it caused his family members, many of whom choked back tears in the courtroom gallery.

But as he had in the past, Reinstein defended his use of clozapine, which he said has been unfairly portrayed by prosecutors as dangerous.

“I’ve been working with this medicine since 1971,” said Reinstein, whose medical license was indefinitely suspended by state regulators in 2014. “It has helped many, many, many patients who were not helped by other drugs.”

First licensed in Illinois in 1968, Reinstein built a lucrative practice providing psychiatric care to mentally ill patients in nursing homes concentrated near his strip mall office in the city’s Uptown neighborhood.
The Tribune-ProPublica investigation found that Reinstein had amassed a worrisome record of assembly line care that was linked to three patients’ deaths and triggered lawsuits as well as accusations of fraud. But the federal charges did not include any accusations of patient deaths.

ct-doctor-kickback-criminal-charge-met-20150205In his plea agreement, Reinstein admitted that, beginning in the 1990s, he prescribed the brand-name version of clozapine to hundreds of his patients while receiving $234,000 from the manufacturer. Reinstein admitted that the payments, ostensibly for speaking engagements touting the drug, were in part for prescribing the drug to so many patients.

When Ivax Pharmaceuticals began making a generic form of clozapine in 2003, Reinstein struck a $50,000-a-year consulting agreement with the company, quickly becoming among its largest prescribers in the country.

Over the next three years, Ivax provided other perks to Reinstein and his associates, including expensive meals, tickets to sporting events and an all-expense-paid trip to Ivax’s headquarters in Miami, where Reinstein went on fishing trips, a cruise and a golf outing, according to prosecutors.

Reinstein faced up to three years in prison but was given a break in his recommended sentence because he cooperated with prosecutors on several other health care fraud investigations, including secretly recording conversations with other doctors, court records show. It was not disclosed whether any of those investigations led to criminal charges.

In asking Coleman for a sentence of a year and half in prison, Assistant U.S. Attorney Eric Pruitt said only 4 or 5 percent of all the patients nationwide who are on antipsychotic drugs are taking clozapine. Meanwhile, the “vast majority” of Reinstein’s patients were on the medication, Pruitt said.

“It is a staggering difference,” Pruitt said.