Subject Numbers Regarding Health Provider Authorizations

Authorization No. 150592-4W

August 19, 2022

Pursuant to Workers' Compensation Law Section 13-d(4), the Chair of the New York State Workers' Compensation Board has exercised her authority to temporarily suspend Dr. Raphael P. Davis' authorization to treat injured workers within the New York State workers' compensation system, effective August 18, 2022. Dr. Davis' last known business addresses are:

Neurosurgery HSC T-12 080
SUNY at Stony Brook
Stony Brook, New York 11794

NY Spine and Brain Surgery
24 Research Way, Suite 200
Stony Brook, New York 11733

NY Spine and Brain Surgery
54 Commerce Drive, Suite 7
Riverhead, New York 11901

The Chair's designee's investigation has revealed that, despite multiple written requests, Dr. Davis has failed and refused to provide the Board with proof of reimbursement of the sum of $4,965.59 to an injured worker's private health insurer, which sum having also been paid to Dr. Davis by an injured worker's workers' compensation insurer for the same treatment.

As a result of the foregoing, the Chair believes that Dr. Davis may be guilty of misconduct under WCL §13-d(2)(f) for the refusal to produce "any relevant book or paper concerning his or her conduct under any authorization granted to him or her under this chapter."

Dr. Davis is prohibited from rendering treatment and care to injured workers, and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR § 324.3(b)(2)(ii)(a), while his authorization is temporarily suspended. Reports submitted by Dr. Davis for services rendered prior to August 18, 2022, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Davis for services rendered prior to August 18, 2022, should not be denied due to the suspension of his authorization.

This suspension remains in effect until further notice. Any questions regarding the authorized lists should be referred to the Medical Director's Office at 1 (800) 781-2362.