MEMORANDUM NO. 2018-03
Peer Reviews Performed by Excel O
|TO:||WCC Commissioners, District Administrators, Advisory Board, Legal Advisory Panel, Medical Advisory Panel, Medical Practitioners, Self-Insureds, Insurance Carriers, Medical Care Plans, Attorneys, and Unions.|
|FROM:||Stephen M. Morelli, Chairman|
|DATE:||June 12, 2018|
|RE:||Peer Reviews Performed by Excel O|
The Connecticut Workers’ Compensation Commission has recently learned that a former New York based orthopedic surgeon, Spyros Panos, whose license to practice medicine was previously suspended, is accused of misappropriating another physician’s identity and fraudulently performing peer/utilization review services.
Currently, the matter is under investigation by federal and New York state authorities. We have reason to believe that a company identified as Excel O LLC may have acted as a peer/utilization review organization and utilized Panos’ assumed medical alter ego to perform peer/utilization reviews. We further believe that some Connecticut Workers’ Compensation insurance carriers may have utilized the peer/utilization review services of Panos under his assumed identity and the peer/utilization review entity known as Excel O LLC.
At this juncture, we are aware that one of the insurers which utilized the allegedly fraudulently based peer/utilization review services of Panos/Excel O LLC is The Hartford. Additionally, there may be a number of other Workers’ Compensation insurance carriers who may have utilized these peer/utilization review services.
The Connecticut Workers’ Compensation Commission has reached out to the Connecticut Insurance Department, the Attorney General and others advising them of this situation. In the meantime, if you are a Workers’ Compensation claimant and are concerned, you should contact the insurance carrier handling your claim. You should ascertain from the carrier if any peer/utilization review services related to your claim were performed as part of this alleged illegal scheme.
We understand that the Hartford is investigating the matter and seeking to develop an action plan that will remediate this problem. We expect, and encourage, other insurance carriers and entities to self report to this Commission any dealings they may have had with Panos, his associated organization and their fraudulent peer/utilization activities.
Any parties impacted by the above that seek additional information, or would like to report additional information to the Connecticut Workers’ Compensation Commission, should contact the Chairman’s office at (860) 493-1500.