Subject Numbers Regarding Health Provider Authorizations

Authorization No. 143966-0W

July 1, 2015

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. Ren-Bang Jan’s authorization to treat injured workers within the New York State workers’ compensation system effective June 24, 2015. Dr. Ren-Bang Jan's last known business address is 91-07 68th Avenue, Forest Hills, New York 11375.

The revocation is based upon Consent Order (BPMC No. 15-114), issued by the New York State Department of Health, State Board for Professional Medical Conduct (BPMC), effective May 12, 2015.

Dr. Jan represented that he is currently retired and agreed to remain permanently retired from active practice in New York State in consideration of the Board and the Director not bringing disciplinary charges against him.

Dr. Jan is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Jan for services rendered prior to June 24, 2015, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Jan for services rendered prior to June 24, 2015, should not be denied due to the revocation of his authorization.

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