Subject Numbers Regarding Health Provider Authorizations

Authorization No. P04933-9B

April 22, 2016

Please be advised that Dr. William A. Holley has resigned his authorizations to treat injured workers and to perform independent medical examinations in the New York State workers’ compensation system effective April 22, 2016. Dr. Holley’s last known practice address is Absolutely Affordable Footcare, 15 Northland Avenue, Buffalo, New York 14208.

Dr. Holley is prohibited from rendering treatment and care to injured workers and from performing independent medical examinations. Reports submitted by Dr. Holley for services rendered prior to April 22, 2016 are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Holley for services rendered prior to April 22, 2016, should not be denied due to the resignation of his authorizations.

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