Amherst Med. Supply, LLC v A. Cent. Ins. Co., 2013 NY Slip Op 51800(U)(App. Term 1st Dept. 2013)
“The peer review report and accompanying affidavit submitted by defendant’s chiropractor failed to set forth a factual basis or medical rationale for his stated conclusion that the medical supplies here at issue were not medically necessary. The peer reviewer’s bald assertion that “I do not find the need for . . . durable medical goods,” was insufficient to meet defendant’s prima facie burden of eliminating all triable issues as to medical necessity.”
This Court tends to scrutinize peer reports and rebuttals more than the Second Department. Thus, while this Court will hold the providers to a higher burden to satisfy the Pan Chiro/CPT Medical test, the proof needed to shift the burden is accordingly higher.
