iFraud Deep Dive

S1 E22 Broken Trust - NY Workers' Comp MD Authorization Denial


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This Deep Dive looks at a denial from the Workers' Compensation Board (WCB)  to Joseph Weinstein, DO, denying the renewal of his authorization to treat injured workers. The WCB cites multiple instances where Dr. Weinstein's treatment deviated from established Medical Treatment Guidelines (MTGs), including performing unjustified invasive surgeries, providing inadequate and inconsistent medical documentation, and engaging in billing irregularities. The denial is highlighting issues such as unnecessary procedures, failure to exhaust conservative treatments, improper documentation of patient progress, and repeated submission of denied authorization requests without escalation or new justification. Ultimately, the WCB concludes that Dr. Weinstein's conduct constitutes professional misconduct, leading to the denial of his authorization renewal and requiring him to transition his current patients to other authorized providers.

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iFraud Deep DiveBy iFraud Foundation