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4 N.J.A.R. 278

Manfredi Surgical, In the Matter of
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Citation: 4 N.J.A.R. 278
Decision Date: 1980
Agency: DIVISION OF MEDICAL ASSISTANCE
Synopsis: Manfredi Surgical requested relief from the denial of payment of a Medicaid claim for the removal of a patient from a body cast. The administrative law judge assigned to the case determined that Manfredi sought payment for the labor necessary to remove a patient from a post-operative scoliosis cast and for measuring, fabricating and fitting the patient into a brace. The judge found that while no agency policy existed either authorizing or precluding Medicaid payment for body cast removal since the petitioner was qualified to perform the service and did so at the request of the attending physician, it should receive payment for the labor involved. Accordingly, the administrative law judge ordered payment to Man- fredi Surgical.