CompFox AI Summary
This case involves a lien claim by National Script Pharmacy for $16,453.92 in compound medications. The Administrative Law Judge initially disallowed the lien, finding the claimant failed to prove the medications were reasonable and necessary. The Appeals Board rescinded this decision, remanding the case to the trial level. This is because the parties need to address the applicability of the Medical Treatment Utilization Standards (MTUS) to the prescribed compound medications, and whether the documentation adequately supported their necessity under these standards.
Full Decision Text1 Pages
This case involves a lien claim by National Script Pharmacy for $16,453.92 in compound medications. The Administrative Law Judge initially disallowed the lien, finding the claimant failed to prove the medications were reasonable and necessary. The Appeals Board rescinded this decision, remanding the case to the trial level. This is because the parties need to address the applicability of the Medical Treatment Utilization Standards (MTUS) to the prescribed compound medications, and whether the documentation adequately supported their necessity under these standards.
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