Subject Numbers Regarding Health Provider Authorizations

Authorization No. 183866-3W

November 28, 2014

Pursuant to Workers' Compensation Law Section 13-d(5), the Chair of the New York State Workers' Compensation Board has exercised his authority to revoke Dr. Eric Jacobson’s authorization to treat injured workers within the New York State workers’ compensation system effective December 2, 2014. Dr. Jacobson's last known addresses are 3 Oakleaf Court, Huntington, NY 11743, and 313 Den Road, Stamford, CT 06903.

The revocation is based upon charges in United States District Court against Dr. Jacobson involving one count of Conspiracy to Distribute a Controlled Substance on or about and between September 2010 and June 2012 when he knowingly and intentionally conspired to distribute oxycodone, a Schedule II controlled substance, contrary to Title 21, United States Code, Section 841(a)(1). The charges also involve five counts of Distribution of a Controlled Substance on or about August 16, 2011, September 8, 2011, October 4, 2011, November 1, 2011, and November 29, 2011, when he knowingly and intentionally distributed a controlled substance, which offense involved a substance containing oxycodone, a Schedule II controlled substance.

Dr. Jacobson had his authorization to treat injured workers temporarily suspended by the Board on July 18, 2012.

Dr. Jacobson is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Jacobson for services rendered prior to July 18, 2012, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Jacobson for services rendered prior to July 18, 2012, should not be denied due to the temporary suspension and subsequent revocation of his authorization.

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