A Florida doctor who recruited workers’ comp patients from public records and allegedly prescribed them compounded drugs during telemedicine visits will be barred from treating injured workers under a settlement agreement with the Florida Department of Financial Services.
Under terms of the settlement, Dr. Samuel J. Gerson will cancel all prescriptions he has written for his workers’ comp claimants. He also agreed to have no affiliation with anyone providing medical treatment for injured workers, and to pay a $5,000 fine.
The settlement, approved on May 11 by Division of Workers’ Compensation Director Tanner Holloman, follows a DFS investigation into Gerson’s billing practices. As part of the agreement, DFS agreed to not refer its case to the Florida Department of Health, which oversees medical licenses. Gerson’s license in Florida is listed as active but under probation.
According to preliminary findings from Florida DFS, Gerson worked with HealthIE Network, later known as Health for the Injured Employee, which solicited workers’ comp claimants for medical exams by Gerson. The telemedicine exams were allegedly conducted without notification of the insurance carrier or claimant’s attorney.
DFS identified 13 claims in which Gerson allegedly billed insurance carriers for the telemedicine visits without preauthorization. A typical visit was billed for two common procedural terminology, or CPT codes, at approximately $80 each.
DFS issued a notice of intent to impose penalties against Gerson on Feb. 3. Gerson’s attorney, Craig Oberweger of Palm Law Partners in Boca Raton, said on Tuesday that he talked with DFS officials about the case and provided them with more information. The settlement followed.
“There was no finding of fault, liability or impropriety against Dr. Gerson,” Oberweger said.
Under the settlement, Gerson does not admit nor deny the preliminary findings or allegations in the notice of intent, with one exception.
“Dr. Gerson admits that the identity of the claimant was learned by reviewing public record data, and Dr. Gerson and/or HealthIE Network LLC solicited the claimants for purposes of Dr. Gerson conducting medical examinations or treatments,” the consent order states.
Gerson got into hot water with the California Medical Board in 2014, when his medical license was suspended for 180 days and he was placed on seven years of probation. Gerson pleaded guilty in 2012 to a misdemeanor charge of forging a narcotic prescription. A year earlier, he pleaded guilty to a misdemeanor count of drunk driving.
A lawyer for Gerson told NBC news in San Diego in 2013 that Gerson had completed a drug rehab program. Gerson was reportedly submitting to random drug tests four to six times a month and was not an “impaired physician,” according to the attorney. Gerson was working at the time in the University of California, San Diego Health System emergency room.
Oberweger, Gerson’s attorney in Florida, said on Tuesday: “Currently Dr. Gerson has an active California medical license, an active Florida medical license, is board-certified in emergency medicine, has an active [Drug Enforcement Agency] license, and is fully compliant with all state and federal rules and regulations regarding the practice of medicine.”
Attorney Paul White-Davis of Morgan, White-Davis & Martinez in Winter Park said he and other claimants' attorneys became concerned last year over an apparent scheme being conducted by HealthIE Network. Company representatives contacted injured workers, leading them to believe the insurance carrier or claimant’s lawyer had asked them to do so, White-Davis said.
Workers were asked to complete paperwork indicating they wanted to switch doctors, White-Davis said. Under Florida’s workers’ comp regulations, claimants are allowed one change of treating physician.
“That undermines the plaintiff attorney’s efforts,” he said.
White-Davis said three or four of his clients were contacted by HealthIE Network. But the calls seemed to stop abruptly in February or March, he said.
HealthIE Network announced in September that it was offering an “innovative telehealth platform” for treating injured workers. One of the “cornerstones” of the platform was “access to innovative pharmacologic management,” the company said in a news release.
“The physicians at HealthIE Network are sensitive to the fact that these patients are in pain, while being cognizant of the problems associated with pain pill addiction,” the news release stated. “Specific care is taken to stage therapy and/or offer pharmaceutical alternatives to commercially available pain medication.”
Nicholas Spagnuolo, who was listed as executive director of operations at HealthIE Network in the September news release, said on Tuesday that he didn’t have any information regarding alleged schemes involving the company. Spagnuolo or other company officials had not called back with any further comment as of Tuesday evening.
Aug 24-25, 2017
The Employers’ Fraud Task Force, in association with The San Bernardino District Attorney’s …
Sep 6-8, 2017
Risk Management Education Associates have announced the keynote speaker for the 2017 CWC & Risk C …
Sep 12-15, 2017
Save the date September 12-15, 2017 Registration will be opening in April 2017. The conferen …