Subject Numbers Regarding Health Provider Authorizations

January 21, 2010

Authorization No. 220993-0W

Please be advised that, effective January 7, 2010, Samir Haddad, M.D., agreed by Consent Order (BPMC No. 09-231) with the New York State Department of Health's Board for Professional Medical Conduct to a three month suspension of his license to practice medicine in this state. The period of suspension ends on or about April 6, 2010. Dr. Haddad is permanently precluded either individually or through a professional corporation from evaluating, treating, or billing patients whose medical services are reimbursed though no-fault insurance or workers' compensation. As a result, Dr. Haddad voluntarily resigned his authorization to treat individuals who have suffered work-related injuries or illnesses, effective January 13, 2010. No current business address is available for Dr. Haddad.

Dr. Haddad is prohibited from rendering medical or other treatment and care to individuals who have suffered work-related injuries or illnesses. Medical reports submitted by Dr. Haddad for treatment rendered prior to January 7, 2010, are valid, but are invalid for any treatment rendered on or after that date. Requests to cross-examine Dr. Haddad regarding treatment he rendered prior to January 7, 2010, should not be denied due to the temporary suspension of his license to practice medicine, his license restriction, or the voluntary resignation of his authorization.

Any questions regarding this matter should be referred to the Office of General Counsel at (518) 486-9564.