Chiropractor sentenced to federal prison for Medicare, insurance fraud

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WHITE PLAINS – A chiropractor, who operated Dolson Avenue Medical with his brother, was sentenced to nine years in federal prison for his participation in a widespread health care fraud scheme through the fraudulent operation of their business, a multi-disciplinary medical clinic in Middletown.

James “Jay” Spina, 63, was sentenced by U.S. District Judge Kenneth Karas in White Plains federal court on Tuesday.

According to legal documents and statements made during court proceedings, Dolson Avenue Medical was a registered medical service corporation that purported to provide a number of pain management and rehabilitation services, including physical medicine and rehabilitation, chiropractic services, physical therapy, diagnostic testing, and acupuncture.

In addition to Dolson Avenue Medical, at least eight other corporations, including four other medical corporations, billed Medicare and other health insurance providers from 201 Dolson Avenue.

On paper, Dolson Avenue Medical and the associated businesses appeared to be separate entities owned by several different qualified individuals, but in reality, James Spina, who is a doctor of chiropractic, not a medical doctor, along with his co-defendant, were the true owners and operators of the different medical service corporations.

As part of the fraudulent scheme, one of the doctors who worked at Dolson Avenue Medical and associated businesses introduced a lucrative procedure called a facet injection. Because the facet joints to which the injections are applied are near the spinal cord, those procedures are high-risk, with a small margin of error.

The doctor had no formal training in the procedure and taught himself by shadowing other doctors and watching YouTube videos.

The federal investigation found that James Spina was intimately involved with all bill-related aspects of the facet injections and continued to encourage their use even after several patients suffered serious, adverse events, and one patient died of complications following a facet injection.

In addition to Spina’s prison term, he was sentenced to three years of supervised release and ordered to pay over $9.7 million in restitution and to forfeit $9.1 million.

Spina pled guilty to one count of conspiracy to commit healthcare fraud on May 2, 2019.