(WWJ) – A Wayne County doctor has been sentenced to more than 16 years in federal prison for his role in an elaborate healthcare fraud scheme that included illegally distributing millions of opioid pills, money laundering and a fraudulent sponsorship of the Ultimate Fighting Championship.
The Department of Justice says Francisco Patino, 68, was the ringleader of the scheme, which resulted in more than $250 million in false and fraudulent claims being submitted to Medicare, Medicaid and other health insurance programs.
Patino also exploited patients suffering from addiction by administering “unnecessary and sometimes painful” injections and illegally distributed more than 6.5 million doses of medically unnecessary opioids, according to the DOJ.
Patino was convicted in September 2021 of multiple charges, including healthcare fraud, conspiracy to commit healthcare fraud and wire fraud, conspiracy to defraud the United States and pay and receive healthcare kickbacks, money laundering and conspiracy to commit money laundering.
Patino owned multiple medical practices and clinical labs across Michigan. He played a critical role in developing and implementing a “shots-for-pills” protocol at several pain clinics.
Under the protocol, the DOJ says patients were required to receive unnecessary back injections in exchange for prescriptions of “dangerous and high doses of medically unnecessary and addictive opioids.”
In exchange for opioids, the patients would receive – or be billed as if they had received – facet joining or nerve block injections, both of which are lucrative spinal injections.
“Although these spinal injections were purportedly intended to treat chronic pain, Patino injected the patients without regard to medical necessity,” officials said. “Evidence also revealed that if patients refused to accept the injections, Patino would withhold their prescriptions for opioids.”
Patino billed Medicare for more of these injections than any other provider in the country between January 2017 and July 2017, according to the DOJ. He also prescribed more 30mg Oxycodone pills than any other provider in the state in 2016 and 2017, officials said.
Authorities say administering injections in exchange for unnecessary opioids “places patients at serious risk of harm and exploits some of the most vulnerable people.”
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Patino also developed an illegal kickback relationship with at least one diagnostic laboratory, from which he was paid in exchange for referring his patients’ samples to that lab. Officials say Patino was aware that his ownership structure and kickbacks violated the law and authored emails acknowledging that such ownership constituted a “violation of the Stark and Anti-Kickback laws.”
He attempted to conceal and disguise the ownership structure and scheme in order to keep himself “out of Federal Prison & having all our assets seized.”
Evidence shows Patino laundered the proceeds of the scheme to “falsely portray himself as a legitimate doctor” through the publication of a diet book and plan described as “the next Atkins.”
He also used paid-for appearances on a nationally syndicated television show, and the sponsorship of boxers, cagefighters, and prominent UFC World Champions and Hall of Famers.
The DOJ says Patino used the money he was making from all these schemes to buy luxury jewelry, cars and international vacations. He was responsible for more than $120 million worth of fraudulent bills submitted to insurers for payment.
Authorities say he “pioneered” the shots-for-pills protocol while working with CEO Mashiyat Rashid of the Tri-County Wellness Group of medical providers in Michigan and Ohio. In 2018, Rashid pleaded guilty to conspiracy to commit health care fraud and wire fraud and money laundering and was sentenced to 15 years in prison on March 3, 2021.
Others convicted at trial or by guilty plea include 12 other physicians who were trained in Patino’s protocols, along with many non-physician defendants who participated in the conspiracy.
The five other defendants most recently sentenced for their part in this scheme include a clinic manager from Hamtramck, a physician from Troy, a physical therapist from Sterling Heights, a home health agency owner from Canton and a physical therapist from Livonia.
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