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A C&R Agreement cannot be used to set aside a fee review determination.

October 1, 2018
Armour Pharmacy v. Bureau of Workers’ Compensation Fee Review Hearing Office (National Fire Insurance Company of Hartford); 1613 C.D. 2017; filed Aug. 7, 2018; President Judge Leavitt

According to the Commonwealth Court, paragraph 10 of the C&R Agreement—stating that the employer would pay reasonable, necessary and related medical expenses incurred before the hearing date—obligated the employer to pay for the medications dispensed by the pharmacy since the expense had already been incurred. The court further noted that a valid C&R Agreement is binding upon the parties, but that in this case the pharmacy was not a party to the agreement. Consequently, the court held that a C&R Agreement to which a provider is not a party cannot be used to deprive that provider of the fee review procedures or to excuse the employer from paying the provider. To do so would violate the Act and due process.  

 

 

Case Law Alerts, 4th Quarter, October 2018

Case Law Alerts is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2018 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. This article may not be reprinted without the express written permission of our firm.

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