Michigan doctor who 'pioneered' a shots-for-pills opioid scheme sentenced to 16.5 years
Dr. Francisco Patino, 68, of Wayne County, Michigan, ran a "shots-for-pills" protocol at pain clinics in which patients received unnecessary back injections, billed to Medicare and Medicaid, in exchange for high-dose opioid prescriptions; patients who refused the injections had their prescriptions withheld. In 2016 and 2017 he prescribed more 30-milligram oxycodone pills than any other provider in Michigan, and he also took kickbacks for referring patient lab samples to a diagnostic laboratory. A federal jury convicted him in September 2021 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. The wider conspiracy, run through pain clinics operating from 2007 to 2018, generated more than $250 million in false claims to Medicare, Medicaid and other health insurers; prosecutors attributed more than $120 million of fraudulent bills specifically to Patino. He was sentenced on January 30, 2023 to 16.5 years in federal prison.
- Year
- 2023
- Where
- United States
- Outcome
- Sentenced
- Reported loss
- $120.0 million
- Victims
- Not stated in the sources
- Schemes
- Pill mill fraud
- Last reviewed
- 2026-10-16
The facts, as recorded
- Dr. Francisco Patino, 68, of Wayne County, Michigan, owned multiple medical practices and clinical laboratories and worked with Mashiyat Rashid, chief executive of the Tri-County Wellness Group, which operated pain clinics in Michigan and Ohio.
- Patino helped create a 'shots-for-pills' protocol: patients had to accept unnecessary back injections, such as facet joint or nerve block injections, in exchange for high-dose opioid prescriptions, and if they refused the injections their prescriptions were withheld.
- From 2016 to 2017, Patino prescribed more 30-milligram oxycodone pills than any other medical provider in the state of Michigan.
- Patino also received kickbacks for referring patients' lab samples to a diagnostic laboratory.
- The wider conspiracy was run through a network of pain clinics that operated from 2007 to 2018, generating more than $250 million in false and fraudulent claims to Medicare, Medicaid and other health insurers, and illegally distributing over 6.6 million doses of opioids.
- A federal jury convicted Patino in September 2021 on charges including 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 was sentenced on January 30, 2023 to just over 16 years (16.5 years) in federal prison.
- Prosecutors said Patino was 'responsible for over $120 million worth of fraudulent bills submitted to insurers for payment.'
- Twenty-one other defendants in the wider Tri-County Wellness Group network were also sentenced.
Why this case matters
Patino’s scheme shows the second, insurance-billing form of a pill mill: the opioid prescription itself was the leverage, not the product being sold, and the thing actually billed to Medicare and Medicaid was a back injection patients were required to accept to get it. That distinguishes it from a purely cash-for-pills storefront, and from this site’s hospice-fraud and medicare-health-insurance pages, which describe fraud against the same federal health programs through different mechanisms entirely.
A protocol, not an improvisation
Prosecutors described a repeatable, deliberate structure, a “protocol,” rather than one doctor’s bad judgment calls. Withholding a prescription from any patient who declined the injection is what turned the clinic’s medical decision-making into a financial lever: the injection reliably generated the higher insurance payout, and tying it to the opioid refill guaranteed patients kept coming back for it.
The caveat
A federal jury convicted Patino in September 2021 after a trial, not a plea, and he was sentenced in January 2023. The facts above come from the Justice Department’s account of the trial evidence and the sentencing, reported directly by FOX 2 Detroit and WILX-TV, not from an unproven accusation.
Sources
- Michigan doctor who led 'shots for pills' opioid scheme gets 16.5 years in prison. FOX 2 Detroit. Accessed 2026-10-16. Supports: Patino's age, location, the Tri-County Wellness Group connection to Mashiyat Rashid, the shots-for-pills protocol and withheld prescriptions, the 2016 to 2017 oxycodone prescribing volume, the September 2021 conviction and specific charges, the $250 million and 6.6 million doses figures for the wider conspiracy, the 2007 to 2018 operating span, the 16.5-year sentence, and the Assistant Attorney General's quote describing the exploitation of vulnerable patients.
- Michigan doctor behind bars for distributing unnecessary opioids. WILX-TV (NBC Lansing). Accessed 2026-10-16. Supports: The January 30, 2023 sentencing date, the $120 million in fraudulent bills attributed specifically to Patino, the lab-referral kickbacks, and the Justice Department quotes that he 'pioneered the shots-for-pills protocol' and was 'responsible for over $120 million worth of fraudulent bills submitted to insurers for payment'.