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Pain clinic owner gets 9 years in prison for role in $80M fraud scheme: 5 details

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James Spina, 63, who owned and operated a Middletown, N.Y.-based pain clinic, was sentenced to nine years in prison for his role in a healthcare fraud scheme, according to an April 13 news release from the office of Audrey Strauss, U.S. attorney for the Southern District of New York.

 

Five things to know:

1. Mr. Spina pleaded guilty to three felony counts of conspiracy to commit healthcare fraud, healthcare fraud and obstruction of a federal audit in 2019. He and his co-conspirators perpetrated a six-year, $80 million fraud scheme.

2. Mr. Spina owned Dolson Avenue Medical, a pain practice providing physical therapy, chiropractic services, diagnostic testing and pain procedures. He also owned and operated at least eight other corporations that he and a co-conspirator concealed to appear as separate entities owned by multiple individuals.

3. The federal government's investigation found Dr. Spina and his co-conspirators submitted claims for medically unnecessary procedures, double-billed, and in some cases billed for services not provided.

4. The fraud also involved a physician performing high-risk facet injections without proper training. The physician allegedly taught himself the procedure by watching YouTube videos and shadowing other physicians. The physician is accused of injuring several patients, and one patient died from complications related to the facet injection.

5. Mr. Spina was ordered to pay $9.8 million in restitution and forfeit $9.1 million. He was sentenced to three years of supervised release after his prison term.

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