Key Takeaway
Park Slope Medical rejected a nonresponsive DME rebuttal in 2013. The decision concerns the evidence for particular supplies, not a three-therapy limit.
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.
The peer reviewer in Park Slope Medical v Praetorian explained why the supplies duplicated care already being provided. The opposing doctor’s affirmation did not answer that reasoning. On May 6, 2013, the Appellate Term, Second Department granted the insurer’s cross motion for summary judgment.
Historical note: Park Slope Medical (2013) granted the insurer summary judgment on a reasoned peer review and a nonresponsive rebuttal, not on a rule that DME is unnecessary whenever a patient receives three therapies.
Last reviewed: September 2026.
Why the rebuttal failed
The peer review identified three therapies the patient was already receiving and explained the doctor’s view that the additional supplies were superfluous. The court found a factual basis and medical rationale in that report. The provider’s affirmation did not meaningfully address its conclusions.
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The appeal followed reargument of an earlier ruling denying the insurer’s cross motion. The appellate court reversed the continued denial and granted dismissal; it did not simply send the parties back for a trial.
The three therapies explain this peer reviewer’s reasoning; they are not a clinical ceiling set by the court. Read it beside Amherst, where the insurer failed to explain its missing-information objection and the treating chiropractor supplied a specific response.
Jason’s original comment
Jason’s May 2013 reaction follows unchanged. His description of judges and his reference to the prior year reflect his perspective at the time, not findings in Park Slope.
Is there something about durable medical equipment that brings out the ire of Appellate Term Justices? Last year, the First Department had something to say about DME. Now a panel of judges, who in my opinion, are not all too friendly to the carriers had this to say:
Connect to the Encyclopedia
- Medical necessity and peer review: topic hub
- Triangle R: defective DME opposition
- Innovative MR Imaging: unsigned and unsworn opposition
- Amherst: identify the missing medical information
- A Plus Medical: an insurer’s insufficient summary-judgment showing
For review of a particular no-fault dispute, contact our office.
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.
