Local chiropractor pleads guilty in health-care fraud case
Times Herald-Record (Middletown, NY)
May 08-- May 8--WHITE PLAINS -- Middletown chiropractor James "Jay" Spina pleaded guilty in federal court to conspiring to defraud health insurers in what federal prosecutors describe as a six-year, $80 million insurance-fraud scheme.
Spina faces a maximum sentence of 10 years for his guilty plea, made Thursday in U.S. District Court in White Plains, to one count of conspiracy to commit health-care fraud, a felony. Sentencing before U.S. District Judge Kenneth Karas is scheduled for Sept. 17.
Spina is the patriarch of the family behind the large multi-specialty orthopedic clinic formerly known as Dolson Avenue Medical. The Spinas changed the clinic's name to the Pain Relief & Wellness Center after an August 2017 FBI raid.
In August, Geoffrey Berman, U.S. Attorney for the Southern District of New York, unsealed a broad federal indictment against practice leaders Jay Spina, 61, and Jeffrey Spina, 57, both of Middletown; Andrea Grossman, 60, of Loch Sheldrake, the clinic's business manager and bookkeeper; and practice administrator Kim Spina, 55, of Woodbourne.
Federal prosecutors charged each with one count of conspiring to commit health-care fraud and one count of health-care fraud. Jay and Jeffrey Spina also were each charged with one count of obstructing and impeding a federal audit, which carries a maximum sentence of five years.
Jay Spina's plea agreement dropped those other charges against him. A spokeswoman for the Southern District'sU.S. Attorney declined to comment on the deal.
Jay Spina's attorney, Michael Burke of Hodges Walsh Messemer & Burke in White Plains, could not be reached for comment.
Jeffery Spina, Kim Spina and Grossman still face their charges. But Kim Spina may be close to a plea deal, according to an April 24 letter sent to Judge Karas by Kim Spina's attorney, Stephen R. Lewis, of Stephens, Baroni, Reilly & Lewis in White Plains.
The federal government's August indictment claims that Jay and Jeffrey Spina, with help from Grossman and Kim Spina, billed insurers for medically unnecessary services and procedures, submitted claims for services not rendered, double-billed for services, fabricated medical records, and concealed the fraud by blocking audits by Medicare and other insurers.
In a separate federal indictment unsealed last August, Berman announced the guilty plea of Charles Bagley, a pain management medical doctor formerly affiliated with Dolson Avenue Medical. Bagley, 69, of Great Neck, a neurologist, pleaded guilty to conspiracy to commit health-care fraud, which carries a maximum sentence of 10 years in prison. U.S. District Judge Nelson Román will sentence Bagley on July 19 in federal court in White Plains.
In addition, Bagley and a Dolson Avenue Medical affiliate are currently named in a pending wrongful-death suit filed by the estate of Debbie Elizabeth Dillinger in February 2018 in state Supreme Court in Orange County.
Dilinger's estate claims that Bagley and the practice botched a cervical spine injection and lacked the equipment to prevent Dillinger from dying of complications.
The Spina family is well-known locally for its long-standing acupuncture, massage, chiropractic and rehab practice, and for philanthropy, including as high-ranking Church of Scientology members helping with the group's local campaign to fight youth drug use.