Subject Numbers Regarding Health Provider Authorizations

Authorization No. 172940-9W

October 31, 2016

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. David Hershan’s authorization to treat injured workers within the New York State workers’ compensation system effective October 19, 2016. Dr. Hershan's last known business address is 118 North Bedford Road, Suite 200, Mount Kisco, New York 10549.

The revocation is based upon Consent Order (BPMC No. 16-334), issued by the New York State Department of Health, State Board for Professional Medical Conduct (BPMC), effective October 18, 2016, wherein Dr. Hershan pled guilty to the specification that he was convicted of Conspiracy to Commit Health Care Fraud, in violation of Section 18 U.S.C. 1349, in the United States District Court, Southern District of New York, resulting in a three (3) month suspension of his license, that his license shall be permanently limited to employment in an Article 28 facility (hospitals only), a $5,000.00 fine, and a sixty (60) month probationary period, during which he must successfully complete a continuing education program in the area of professional ethics.

Dr. Hershan is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Hershan for services rendered prior to October 19, 2016 are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Hershan for services rendered prior to October 19, 2016, 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.