Key Takeaway
Neomy's physician did not justify additional studies. Compare the 2012 dismissal with Quality Psychological and successful treating-provider letters.
This article is part of our ongoing medical necessity coverage, with 171 published articles analyzing medical necessity issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Neomy’s supervising physician did not explain why the additional studies were needed. That omission left the insurer’s medical rationale unanswered and led to dismissal.
The insurer’s showing and the missing response
Neomy Medical v American Transit, 2012 NY Slip Op 50769(U), decided April 25, 2012, reversed an order that had favored the provider. The Appellate Term, Second Department, found timely denial, a sufficient peer review and a supporting affidavit from the reviewer.
The provider’s supervising physician failed to justify the additional studies with specificity. Applying Pan Chiropractic v Mercury, the court found no triable issue, denied the provider’s motion and granted the insurer’s cross motion dismissing the complaint.
Why Jason compared it with Quality Psychological
In Quality Psychological Services v Mercury, 2010 NY Slip Op 50601(U), a sworn letter from the psychologist who examined the patient was enough to raise a factual dispute. Neither side obtained summary judgment. Jason questioned whether the different outcomes reflected the treating professional’s role or a change in the amount of evidence required.
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Those remain questions in his dated commentary. The two opinions do not reproduce all the medical submissions. They do not establish that Quality accepted a content-free letter or that Neomy changed the governing standard.
Compare the reviewer’s reason for rejecting the services with the physician’s explanation for ordering them. See also Complete Radiology’s successful physician letter, decided the month before Neomy. Its outcome is another reason not to describe 2012 as a simple shift toward stricter opposition requirements.
Jason’s original comment
Jason’s May 2012 questions compared Neomy with Quality Psychological. They remain historical questions, not proof of a later change in law.
Does a treating doctor’s affidavit need to have less in it than a plaintiff peer doctor?
Has the quanta of evidence necessary to raise an issue of fact increased in two years since Quality v. Mercury?
I do not have an answer.
Historical note: Neomy’s April 2012 decision applies Pan Chiropractic to an unexplained need for additional studies; it does not establish that the court overruled Quality Psychological or imposed a new treating-doctor rule.
Last reviewed: September 2026.
Connect to the Encyclopedia
Start with the medical necessity and peer review hub.
- A treating-physician letter that raised a factual issue: Complete Radiology
- An IME rebuttal that did not address the examiner: Eastern Star
- Conflicting physical-therapy opinions: DRD Medical
- A fee-schedule win alongside a medical-necessity dispute: Plutno
For review of a particular no-fault dispute, contact the firm with the denial and supporting medical papers.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Medical Necessity Disputes in No-Fault Insurance
Medical necessity is the most common basis for no-fault claim denials in New York. Insurers hire peer reviewers to opine that treatment was not medically necessary, shifting the burden to providers and claimants to demonstrate otherwise. The legal standards for establishing and rebutting medical necessity — including the sufficiency of peer review reports, the qualifications of reviewing physicians, and the evidentiary burdens at arbitration and trial — are the subject of extensive case law. These articles provide detailed analysis of medical necessity litigation strategies and court decisions.
171 published articles in Medical Necessity
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a medical necessity matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
