But the data might not reveal his true impact on the prescriptions of his patients.
State records showed he had treated at least 1,557 patients enrolled in both Medicare and Medicaid, mostly nursing-home residents, in 2003. It is common for consulting psychiatrists such as Jerusalem to recommend drugs for patients, while the actual prescriptions are then written by physicians who work as medical directors for the nursing homes. Assessing the allegations against Jerusalem would require a review of confidential patient medical records to show that he recommended a drug that was later prescribed by another doctor.
Prosecutors could conduct such a review with a subpoena, but federal patient privacy laws would shield the records from reporters.
Asked for substantiation, attorneys for Woodward said his claims were based on memory because he was not allowed to take his records when he was fired. They said the government found him to be a trustworthy source. Woodward did not return calls for comment.
Two government lawyers involved in the case would not comment on it but said the Justice Department typically focuses on whether the allegations in a suit support a pattern of behavior by the company. The department does not vouch for whistleblowers’ specific claims about individual doctors.
Brian Kenney, a Woodward attorney, said that he pushed prosecutors to pursue the psychiatrist because his conduct was “egregious” but that they were not interested.
“Dr. Jerusalem’s conduct is tantamount to elder abuse,” the suit alleged.
Boards don’t follow up
When physicians are accused of sexual misconduct, medical malpractice or criminal behavior, medical boards typically launch investigations and impose public discipline if justified.
Medical-board officials in several states, however, said they could not recall any cases in which a doctor had been sanctioned for taking a kickback from a drug company or being part of a company’s plan to market drugs “off-label” — for uses that are not approved by the FDA.
Russell Aims, chief of staff for the Massachusetts Board of Registration in Medicine, said such cases are hard to prove because physicians can always claim they are prescribing and promoting a drug because they believe in it — not because of the money they are being paid.
“It’s not like a wrong-site surgery, like sexual misconduct, like getting popped for a DWI,” where the evidence is clear-cut, Aims said.
Further, many whistleblower suits are filed in federal courts and never referred to state officials. Some former federal prosecutors said such suits should be routinely forwarded to state medical boards.