A spinal surgeon at a well-known Long Island-based medical firm, who also helps operate Nassau University Medical Center’s orthopedics department, has been barred from treating patients with workers' compensation claims, records obtained by Newsday show.

In an April 15 letter first made public last week and obtained by Newsday, the State Workers’ Compensation Board informed Dr. Vadim Lerman, the associate director of spine surgery at Total Orthopedics & Sports Medicine, who holds the same title at NUMC, that they were rejecting the renewal of his application allowing him to seek reimbursement for the treatment of injured workers. The letter accused Lerman of "billing irregularities," inadequate medical recordkeeping and performing "highly invasive" surgeries without medical justification.

The top leadership at Total Orthopedics, which has four Nassau County locations, simultaneously operate the Orthopedics Department at NUMC, the cash-strapped public hospital whose oversight board was recently taken over by the state.

In fact, NUMC’s website states "clinical supervision of NUMC’s Orthopedics Department is provided by Total Orthopedics & Sports Medicine."

In an emailed statement responding to the Workers' Compensation letter, Total Orthopedics & Sports Medicine said it "looks forward to the opportunity to vigorously refute these baseless allegations in a legal forum and stands by its stellar reputation for exceptional medical care that it and its award-winning physicians have provided for more than two decades."

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.

Portal from Total Ortho to NUMC

Court records reviewed by Newsday allege surgeons at Total Orthopedics often see patients — typically litigants in lawsuits stemming from accidents in Brooklyn — and then direct them to spinal surgery at NUMC, which they or their colleagues later perform.

In many instances, those surgeries are performed on individuals without insurance, so the costs of the expensive procedures are absorbed by the hospital, which is already $1.4 billion in debt, court records show.

As a safety net public hospital, NUMC is required to provide treatment to all patients who comes through its emergency room, regardless of their ability to pay.

Lerman, a board-certified orthopedic spine surgeon who holds staff appointments at Beth Israel Medical Center, Mount Sinai South Nassau, NUMC and at Northwell Health hospitals, did not return multiple requests for comment.

In a statement, Stuart Rabinowitz, NUMC's new board chairman and the former Hofstra University president, called the letter "a matter of serious concern. While the Board is newly appointed and quickly beginning its work, we plan to thoroughly investigate the circumstances and, of course, fully cooperate with all government agencies involved their investigations of the situation."

Messages left with NUMC and Gov. Kathy Hochul's office were not returned. A spokesman for the Nassau Interim Finance Authority, an oversight board with control of NUMC’s finances, declined to comment.

The Workers’ Compensation Board authorizes health care providers statewide to perform independent medical examinations and to treat injured workers. When providers are not authorized by the board, they can no longer treat injured workers who have workers’ compensation claims.

Providers are required to reapply for authorization every two or three years, in line with their State Education Department license renewal, said Missy Stewart, a board spokeswoman.

In the case of Lerman, however, the investigation was prompted by a complaint filed by attorneys who sued Total Orthopedics in federal lawsuits involving alleged staged accidents.

"A serious enough complaint may warrant review of authorization at any time and, where appropriate, rescission of authorization before the end of an authorization period," Stewart said in a statement, adding the board routinely refers cases to regulatory and professional oversight boards. "While the removal and or nonrenewal of a practitioner is not especially common, it does occur with a fair amount of frequency."

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Surgeries 'lacked medical justification'

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," they wrote.

The claims, Tacci and Papa wrote, exposed claimants to the risk of injury and complications from invasive surgeries; lacked credible documentation that failed to meet acceptable standards of medical record keeping; involved billing irregularities, and "lacked medical justification or clinical indications for these procedures, calling into question the clinical judgment utilized in this medical decision-making."

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 scans 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 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.

Staged accidents lawsuit

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."

Attorney Dan Johnston, who filed the lawsuit on behalf of the Willis Law Group, a Texas-based firm, credited the Workers' Compensation Board with taking "necessary steps to protect the patients that come before this doctor. We have labeled the systemic fraud in New York State as the 'fraudemic.' And as our investigation moves forward and our racketeering cases are heard by the courts, hopefully we will see change to ensure that the citizens of New York State are protected by the very people who took the oath to do no harm."

Jeffrey Gold, a North Bellmore attorney involved in roughly 20 additional cases in which Total Orthopedics and its doctors are named, said virtually all of the claimants were brought from the five boroughs for expensive surgeries at NUMC.

"We found it odd that so many New York City residents were opting for this orthopedic group and surgery at NUMC," Gold said. "It made no sense."

Last month, Hochul signed legislation shifting control of NUMC and its 11-member board to appointees selected by the governor and majority state lawmakers, in this case Democrats, and away Nassau County Executive Bruce Blakeman, a Republican. The county executive has accused Hochul of orchestrating a "takeover" of Long Island's only public hospital.

Newsday reported last month that Nassau Health Care Corp., or NuHealth, which oversees the hospital, reported a deficit of $1.4 billion at the end of last year. Yearly operating losses at NUMC have steadily increased, from $102 million in 2020 to $144 million in 2024, Newsday has reported.

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