Newsday: NUMC launches investigatory review of surgical cases performed by orthopedics department doctors, officials say

By: Robert Brodsky

Nassau University Medical Center's newly configured board of directors has launched an investigatory review of surgical cases at the East Meadow hospital performed by doctors from Total Orthopedics & Sports Medicine and plans to reduce the company's outsized role in its orthopedics department, officials tell Newsday.

The review comes as NUMC confirmed that Dr. Vadim Lerman, who previously served as the hospital's associate director of orthopedic spinal surgery — a title he also holds at Total Orthopedics — has not held medical staff privileges allowing him to treat patients there since June 19.

The State Workers' Compensation Board has accused Lerman of performing medically questionable procedures without justification and rejected an application that would allow him to continue seeking reimbursement for the treatment of injured workers.

Internal review of Total Ortho docs

The NUMC board launched a review to determine whether other surgeons at Total Orthopedics — which operates the hospital’s orthopedics department — engaged in similar conduct, officials said.

"Following the Workers' Compensation Board’s findings of care, billing, and documentation issues, NUMC’s new leadership engaged an outside expert to review cases to verify the allegations and assess any broader involvement," Tommy Meara, a NUMC spokesman, said in a statement. "This review is ongoing, and NUMC remains committed to the highest standards of care and full compliance with legal and ethical obligations."

At least five Total Orthopedics surgeons, including Lerman, are still listed among the clinical staff of NUMC's Orthopedics Department.

"Upon learning of these allegations, the new leadership team has been evaluating other groups to help support the Orthopedics Department and anticipates that Total Orthopedics will play a smaller role in its orthopedic practice, specifically with regard to spine surgery, and subject to enhanced oversight," Meara said.

An attorney for Lerman, who is challenging the Workers’ Compensation Board’s decision, did not respond to requests for comment, as did a spokesman for Total Orthopedics, which has three Nassau County and one Suffolk County locations.

The oversight board of NUMC, Long Island's only public hospital, was taken over by the state earlier this year.

Lerman, of Old Westbury, and Total Orthopedics were named as defendants in at least four federal Racketeer Influenced and Corrupt Organizations (RICO) lawsuits, including one alleging they conspired with Freeport residents, a Manhattan law firm and a vast network of other medical providers to collect millions in insurance payouts for fraudulent accident claims.

No one has been criminally charged in connection with the cases, but the Brooklyn District Attorney's Office, which has declined to comment, has opened a criminal investigation connected to the RICO complaints, court records show.

Lerman, a board-certified orthopedic spinal surgeon, resigned his privileges at all Northwell Health medical facilities in July, according to a hospital spokeswoman.

It was not clear if he continues to have privileges at Mount Sinai South Nassau hospital in Oceanside, which did not respond to requests for comment.

'Invasive' surgeries without justification

In April, the Workers' Compensation Board rejected the renewal of Lerman’s biennial application allowing him to seek reimbursement for the treatment of injured workers, accusing the surgeon of "billing irregularities," inadequate medical recordkeeping and performing "highly invasive" surgeries without medical justification in at least five cases.

That board also criticized him for opting for "predetermined" surgical procedures after only an initial consult, without full patient evaluations or exploring more conservative treatment options — including on patients as young as 24 — and without sufficient documentation to support the treatment.

Lerman has denied the allegations, with his attorney arguing in court records that the board’s decision "was not the product of a fair or objective regulatory process. Instead, it was driven by speculation, mischaracterizations of clinical care, and disregard for basic due process protections."

In mid-August, Lerman filed a petition in state court in Schenectady County seeking to annul the state's denial, which his attorneys described as "arbitrary, capricious and unlawful."

The case is due back in court next month.

Court records reviewed by Newsday show a frequent portal between Total Orthopedics locations and NUMC.

Attorneys representing insurance companies in the RICO cases allege that surgeons at Total Orthopedics often see patients — typically litigants in lawsuits stemming from alleged accidents in Brooklyn and across the five boroughs — and then direct them to spinal surgery at NUMC in East Meadow, which they or their colleagues later perform.

Those often expensive surgeries are often performed on individuals without insurance, so the costs of the procedures are absorbed by the hospital, which is $1.4 billion in debt, records show.