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MATTER OF POLANCO v. COMM'R OF THE DEP'T OF SOC SERVS. OF THE STATE OF NEW YORK

212 A.D.2d 443 (1995)

622 N.Y.S.2d 932

In the Matter of Machado Polanco, Petitioner, v. Commissioner of the Department of Social Services of the State of New York, Respondent

Appellate Division of the Supreme Court of the State of New York, First Department.

February 21, 1995

Medicaid providers are required to maintain adequate records of diagnoses, patient histories, and reasons justifying tests or prescriptions so that "the medical necessity for and the nature and extent of the medical care, services or supplies furnished" can be ascertained (18 NYCRR 515.2 [b] [6]; Matter of Adrien v Kaladjian, 199 A.D.2d 57). A provider who fails to maintain records that fully disclose the medical necessity for and...

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