James Spina, 63, was sentenced to 108 months in prison for his participation in a widespread healthcare fraud scheme through the fraudulent operation of Dolson Avenue Medical (“DAM” or the “Practice”), a multi-disciplinary medical clinic located in Middletown, New York. In addition to the prison term, he was sentenced to three years of supervised release and ordered to pay $9,760,555.20 in restitution, and to forfeit $9,105,741.61. According to the Indictment, other court filings, and statements made during court proceedings: From 2011 through September 2017, DAM was a registered medical service corporation in New York State that purported to provide a variety of pain management and rehabilitation services, including physical medicine and rehabilitation, chiropractic services, physical therapy, diagnostic testing, and acupuncture. In addition to DAM, at least eight other corporations, including four other medical corporations, billed Medicare and other health insurance providers. On paper, DAM and the Associated Businesses appeared to be separate entities owned by multiple 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 DAM and the 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, such procedures are high-risk, with a small margin for error. The doctor had no formal training in the procedure, and taught himself by shadowing other doctors and watching YouTube videos. James Spina was intimately involved with all billing-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.
