SK Prime Med. Supply, Inc. v State Farm Mut. Auto. Ins. Co., 2014 NY Slip Op 50630(U)(App. Term 2d Dept. 2014)
This is the first application of “Great Wall” outside the realm of the acupuncture fee schedule. It is great to see meritless appeals create good case law.
” Finally defendant’s submission of its claims representative’s affidavit, along with a copy of the “NYS Medicaid DME Services Fee Schedule,” which has been adopted as the Durable Medical Goods Fee Schedule for Workers’ Compensation (see 12 NYCRR 442.2 [a]), was sufficient to demonstrate that plaintiff was entitled to receive $22.04 for Code E0190, the sum defendant has already paid, and not $24.00, the sum that plaintiff had billed (see Great Wall Acupuncture, P.C. v GEICO Ins. Co., 26 Misc 3d 23 [App Term, 2d, 11th & 13th Jud Dists 2009]).”
