Subject Numbers Regarding Health Provider Authorizations

Authorization No. 143168-3W

October 4, 2021

Please be advised that Dr. Gideon Hedrych has resigned his authorization to treat injured workers in the New York State workers' compensation system effective December 31, 2021. Dr. Hedrych's practice address is:

Mid-Manhattan Medical, P.C.
a/k/a Park Avenue Trauma Associates
100 Livingston Street, Suite 2
Brooklyn, New York 11201

Please take note that, during the period until his full resignation, effective December 31, 2021, Dr. Hedrych shall not accept as a new patient any workers' compensation claimant after October 15, 2021, and shall not, unless requested by the Worker's Compensation Board, render an opinion, by the filing of Doctor's Report of MMI/Permanent Impairment (Form C-4.3) or by any other means, as to maximum medical improvement and/or permanent impairment regarding any workers' compensation claimant after October 15, 2021.

Effective December 31, 2021, Dr. Hedrych is prohibited from rendering treatment and care to injured workers, from billing for any services for which the fees for such services are set by the Official New York State Workers' Compensation Medical Fee Schedule, and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR § 324.3(b)(2)(ii)(a). Reports submitted by Dr. Hedrych for services rendered prior to December 31, 2021, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Hedrych for services rendered prior to December 31, 2021, should not be denied due to his resignation.

Any questions regarding the authorized lists should be referred to the Medical Director's Office at 1 (800) 781-2362.