James Spina to Serve 108 Months, Pay More than $18 Million in Restitution and Forfeiture; Co-Conspirators Await Sentencing
Spina pled guilty to one count of conspiracy to commit healthcare fraud and today was sentenced to serve 108 months (nine years) in federal prison, plus three years of probation and pay $9.7 million in restitution and forfeit $9.1 million.
"Mr. Spina orchestrated a massive criminal health insurance fraud which systematically defrauded the state, federal and private insurers of millions of dollars,” DiNapoli said. “This type of fraud harms all New Yorkers and contributes to higher health care costs across the state and country. Thanks to my partnership with U.S. Attorney Audrey Strauss, the FBI, the U.S. Department of Health and Human Services Inspector General and the Orange County Sheriff's Office, Mr. Spina has been held accountable."
U.S. Attorney Audrey Strauss said: “James Spina led a sophisticated, widespread, and callous scheme that put greed and profits ahead of patients and their well-being. In doing so, he betrayed his professional obligations and bilked insurance companies and Medicare out of millions of dollars. Thanks to the coordinated efforts of federal and state investigative agencies, Spina will now serve a lengthy sentence in federal prison.”
In 2018, Spina and three others were charged with billing insurers for medically unnecessary services and procedures, submitting claims for services not rendered, double-billing for services, fabricating medical records and concealing the fraud by blocking audits. The submitted claims totaled more than $80 million.
All four individuals who were charged have pleaded guilty.