Wednesday, August 7, 2013

Through the looking glass

"it seemed like I had just read it"

 Following receipt of the billing, the Respondent carrier arranged through Transcion Medical Service, a peer review with Dorothy Scarpinato, M.D. whose report of April 4, 2012 is contained in the ECF. Dr. Scarpinato’s peer review contains on page 2 a brief discussion session which is identical (word for word) with a peer review arranged with the same service Transcion Medical and Pierce Ferriter, M.D. which peer review is contained in AAA Case #412013029199. Consequently, I cannot give any credit or credibility to the peer review as it is not only non-persuasive but it is canned, deceitful and potentially fraudulent that this Transcion Medical Service would slap together a discussion and conclusion on a variety of peer review reports discussing durable medical equipment with various providers that are in their stable of providers and consequently this peer report has no credibility with me whatsoever. It is more than a mild coincidence and only the luck of the draw of the cases that they happen to be back to back on my hearing schedule so that having reviewed the earlier one, when I reviewed Dr. Scarpinato’s opinion here it seemed like I had just read it and in fact I just had read it.
Now you may be thinking "What has the Department of Financial Services (Superintendent Benjamin M. Lawsky) done about this obvious and reoccurring practice by IME/Peer doctors and the vendors that pay them Not a damn thing.  Ok, maybe you are thinking "well, if Mr. Lawsky is willing to let this practice slide, surely the Attorney General (Eric Schneiderman) has done something."  Nope, not a damn thing.  Now you might think "well, the OPMC is always there, just in case everyone else is willing to let this slide."  

You are sadly mistaken.

1 comment:

  1. The only way that the Department of Financial Services can do anything about this is if they receive copies of these reports. Anyone can submit a complaint to the NYSDFS through its website. These decisions should be mailed to A/G's office. These agencies are not going to obtain this information through osmosis.