Michigan Doctor Sentenced to More Than 16 Years for His Role in Healthcare Fraud, ‘Shots-for-Pills’ Scheme

by Scott McClallen

 

A Michigan doctor was sentenced to 16.5 years in prison for his part in a health care fraud scheme that billed more than $250 million in fraudulent claims to Medicare, Medicaid, and health insurance programs and illegally distributed over 6.6 million doses of opioids.

In September 2021, Francisco Patino, M.D., 68, of Wayne County, was convicted at trial in the Eastern District of Michigan of conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to defraud the United States, and pay and receive health care kickbacks, conspiracy to commit money laundering, and money laundering.

Patino joins 21 other defendants who were previously sentenced for participating in the same scheme.

“This defendant exploited vulnerable patients struggling with addiction by overprescribing highly dangerous opioid pills and exposing them to unnecessary and sometimes painful injections,” said Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division.

Court documents say Patino owned multiple medical practices and clinical laboratories in Michigan. Prosecutors say Patino helped develop and implement a “shots-for-pills” protocol at several pain clinics. Patients were required to receive unnecessary back injections in exchange for prescriptions of dangerous and high doses of medically unnecessary and addictive opioids.

Prosecutors said that Patino’s spinal injections weren’t medically necessary and that if patients refused to accept the injections, Patino would withhold their opioid prescriptions.

From January 2012 through July 2017, Patino billed Medicare for more of these injections than any other provider in the country. In 2016 and 2017, Patino prescribed more 30-milligram Oxycodone pills than any other provider in Michigan.

“The significance of this sentence underscores the severity of the conduct by the defendant in this investigation,” Special Agent in Charge Mario M. Pinto of the Department of Health and Human Services Office of Inspector General, said in a statement. “In particular, the administration of unnecessary injections, in exchange for unnecessary opioid prescriptions, places patients at serious risk of harm and exploits some of the most vulnerable people.”

Prosecutors say Patino developed an illegal kickback relationship with at least one diagnostic laboratory. Emails show that Patino was aware his ownership structure and kickbacks violated the law and constituted a “violation of the Stark and Anti-Kickback laws,” and attempted to conceal and disguise the ownership structure and scheme to keep himself “out of Federal Prison & having all our assets seized.”

Law enforcement says that Patino laundered scheme proceeds to falsely portray himself as a legitimate doctor through the publication of a diet book and plan described as the “next Atkins,” paid-for appearances on a nationally syndicated television show, and the sponsorship of boxers, cage fighters, and prominent Ultimate Fighting Championship World Champions and Hall of Famers.

The DOJ says Patino also spent funds from these various schemes on luxury jewelry, cars, and international vacations. Between the spinal injections and kickback-induced laboratory testing, Patino was responsible for over $120 million worth of fraudulent bills submitted to insurers for payment.

– – –

Scott McClallen is a staff writer covering Michigan and Minnesota for The Center Square. A graduate of Hillsdale College, his work has appeared on Forbes.com and FEE.org.
Photo “Francisco Patino” by The Patino Diet. Background Photo “Courtroom” by Carol M. Highsmith.

 

Related posts

Comments