State bans prominent Nassau spine doctor over ‘unjustified’ surgeries: report

The state has pulled the plug on a prominent spinal surgeon’s ability to treat injured workers.

Vadim Lerman, who serves as associate director of spine surgery at both Total Orthopedics & Sports Medicine and Nassau University Medical Center in East Meadow, is accused of “billing irregularities” and unjustified invasive surgeries, Newsday reported.

The surgeon received an April 15 rejection letter (scroll down to read the letter) from the State Workers’ Compensation Board, accusing him of inadequate medical record keeping and performing “highly invasive” surgeries without proper medical justification.

The 19-page disciplinary letter, initially obtained by Newsday for its report, detailed five questionable medical claims where Lerman allegedly opted for “predetermined” surgical procedures after initial consultations — including on patients as young as 24 — without exploring conservative treatment options or conducting full patient evaluations.

Board officials James Tacci and Michael Papa criticized the surgeon for failing to correctly read MRI scans and providing minimal post-surgical care, calling his behavior “a wanton disregard and deviation from the standard of care.”

Lerman, according to his Total Orthopedics bio, “specializes in minimally invasive spine surgery, including herniated discs of the neck and back, stenosis, and nerve problems.” He also specializes in “complex treatment of deformities, tumors, degenerative disease and trauma involving the cervical, thoracic and lumbar spine.”

The Workers’ Compensation Board found that the spine doctor’s conduct “frequently, and in many instances repeatedly”:

• Exposes claimants to risks of injury and complications from invasive procedures.
• Lacks adequate and/or credible documentation, frequently failing to meet generally acceptable standards of medical record-keeping.
• Lacks medical justification or clinical indications for these procedures, calling into question the clinical judgment utilized in this medical decision-making.
• Demonstrates the submission of prior authorization requests (PAR) to perform procedures outside of those generally provided for within the MTGs (variance PARs) without the requisite supporting medical justification.
• Exhibits billing irregularities in billing practices for such procedures.

Total Orthopedics, which has offices and sees patients on Long Island and in New York City and New Jersey, dismissed the workers’ compensation allegations as “baseless” and said it would “vigorously refute” them in court, while NUMC’s new board chairman called the letter “a matter of serious concern” requiring thorough investigation, Newsday reported.

The 19-page letter

The disciplinary action comes as Lerman and Total Orthopedics face federal racketeering lawsuits alleging their involvement in a widespread fraud scheme involving staged accidents, according to the report from Newsday’s Robert Brodsky.

Court records, the report said, show surgeons at the practice often see patients from Brooklyn accident cases and direct them to spinal surgery at NUMC, with costs absorbed by the already $1.4 billion debt-ridden public hospital when patients lack insurance.

_{Top photos: Vadim Lerman (inset/Facebook) and Total Orthopedics (Google Maps).}