Park Slope Med. v Praetorian Ins. Co., 2013 NY Slip Op 50761(U)(App. Term 2d Dept. 2013)
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:
“Defendant submitted a sworn peer review report which set forth a factual basis and medical rationale for the doctor’s determination that there was a lack of medical necessity for the medical supplies at issue, in that the supplies were superfluous, given that the assignor was already receiving three forms of therapy, which the peer reviewer stated was “more than adequate.” In opposition, plaintiff submitted an affirmation by a medical doctor which failed to meaningfully refer to, let alone rebut, the conclusions set forth in the peer review report”
