A spinal surgeon at a well-known Long Island medical firm was recently barred from treating patients with workers compensation claims due to excessive “‘billing irregularities,’ inadequate medical record-keeping and performing ‘highly invasive’ surgeries without medical justification.” Newsday published in their report:
“In their 19-page letter, Dr. James Tacci and Michael Papa, medical director and deputy counsel, respectively, of the Workers’ Compensation Board, detailed five questionable recent medical claims filed by Lerman in which prior authorization requests were rejected, but in which risky surgical procedures were performed nonetheless by doctors in his practice. These claims appear to indicate a consistent series of noncompliant behaviors that deviate from the expected standard of care and administrative standards of professional behavior.”
“In the cases detailed by the board, Lerman was criticized for opting for ‘predetermined’ surgical procedures after only an initial consult, without full evaluations of the patient or exploring more conservative treatment options — including on patients as young as 24 — and without sufficient documentation to support the treatment.”
“The letter also cited examples of Lerman failing to correctly read MRI imaging or deliberately ‘misrepresenting’ their results and performing minimal postsurgical care, which altogether represent ‘a wanton disregard and deviation from the standard of care.’
The letter concluded that Lerman’s behavior amounts to professional misconduct’ and directed the doctor to transition the care of any patient who has claims with the board to another medical provider.”
The inquiry was initiated after law firms filed federal lawsuits against Total Orthopedics, noting the medical firm orchestrated staged accidents with billboard attorneys.
“Total Orthopedics and Lerman personally were recently named as defendants in several recent major federal lawsuits, including one alleging they conspired with a group of Freeport residents, a Manhattan law firm, and a vast network of other medical providers to collect millions of dollars in insurance payouts for bogus accident claims.”
“Newsday reported last month that Total Orthopedics, Lerman and Dr. Dante Leven, the firm’s director of minimally invasive spine surgery and an orthopedic spine surgeon and teacher at NUMC, were named in a federal racketeering lawsuit alleging a widespread fraud scheme involving staged accidents that included lawyers, financiers, doctors, surgeons, radiologists and pain management specialists. None of the defendants named in the suit have been criminally charged.”
“The unidentified Long Islanders involved in the scheme, the suit contends, were instructed by law firm employees ‘to fake their injuries and to receive myriad health care services that were unnecessary, excessive, unjustified and costly and/or not causally related to the alleged accidents.’”
This instance is one of many claims against doctors and lawyers working together to further their scheme to defraud consumers and fill their own pockets. Consumers, lawmakers, and professionals alike are finally taking notice, realizing the need for reform is now.
We need a more transparent legal system that ensures just and equitable compensation for victims in court, while also providing consumers with the assurance that they can consult a doctor, confident that they are receiving appropriate care for their injuries.