In what could only be described as a groundbreaking decision, the Appellate Term, Second Department, held in Urban Radiology, P.C. v. Tri-State Consumer Insurance Company,1 that a peer review doctor, in forming his opinion as to the medical necessity of the services and supplies in dispute, could rely upon medical records not in evidence prepared by third-party medical providers who also treated the assignor with respect to injuries sustained in the same automobile accident.
While some lower courts in the Second Department had permitted a peer review doctor to testify at trial based upon his review of medical records prepared by third-party providers that were not in evidence,2 the decision in Urban Radiology constitutes the first time that the Appellate Term, Second Department, has expressly allowed such testimony by a peer review doctor despite the hearsay objections of the plaintiff’s counsel.3 Thus, it is the authors’ opinion, that the decision in Urban Radiology represents a fundamental sea change in the law that will alter the way in which medical necessity trials will be conducted in the future.
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