5 plead guilty in $80M healthcare fraud scheme: 8 things to know

Written by Angie Stewart | August 13, 2019 | Print  | Email

Five individuals who practiced at and operated a New York pain facility pleaded guilty in a six-year, $80 million healthcare fraud scheme, according to the Times Herald-Record.

Eight things to know:

1. Prosecutors said the fraud scheme took place at Middletown, N.Y.-based Dolson Avenue Medical, which was renamed the Pain Relief & Wellness Center after an FBI raid in August 2017. The facility offers chiropractic care, acupuncture, physical therapy and other services.

2. The clinic's business manager and bookkeeper, Andrea Grossman, pleaded guilty Aug. 1 to one felony count of conspiracy to commit healthcare fraud. She is set to be sentenced on Nov. 6.

3. Chiropractor Jeff Spina, DC, pleaded guilty July 26 to three felony counts: conspiracy to commit healthcare fraud, healthcare fraud, and obstruction of a federal audit. Each carries a maximum 10-year sentence. His sentencing is scheduled for Oct. 24.

4. Medical practice administrator Kim Spina pleaded guilty on June 18 to healthcare fraud and conspiracy to commit healthcare fraud. Her sentencing is scheduled for Oct. 10.

5. James "Jay" Spina, DC, pleaded guilty on May 2 to conspiring to defraud health insurers. His sentencing is scheduled for Sept. 17. James, Kim and Jeff Spina are siblings.

6. Jeff and Jay Spina could lose their chiropractic licenses because of the felony convictions. The indictment alleges the brothers operated at least eight other businesses that fraudulently billed Medicare and other insurers.

7. Pain Relief & Wellness Center remains open under chiropractors David Spina, DC, Tracy Parrino, DC, and Stephen Brune, DC.

8. Along with the one involving the Spina siblings and Ms. Grossman, a federal indictment against neurologist Charles Bagley, MD, was unsealed in August 2018. Dr. Bagley was a pain management physician at Dolson Avenue Medical. He pleaded guilty to conspiracy to commit healthcare fraud and will be sentenced on Dec. 13.

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