A Dispenser of Durable Medical Equipment is Not a Health Care Provider Under Section 109 of the Act and Therefore May Not Seek Recourse Through the Medical Fee Review Process

Scomed Supply v. Hartford Accident & Indemnity Co. and Sedgwick Claims Management Services (Bureau of Workers’ Compensation Fee Review Hearing Office); No. 79 C.D. 2025; filed April 16, 2026; by Judge Wolf.

Scomed, a retail seller of medical supplies, dispensed electrodes, batteries, lead wires, moisturizer, and alcohol wipes necessary for use of a TENS unit prescribed to the claimant for a work injury. Scomed billed Hartford Accident & Indemnity Co. for the goods on ten occasions.  The insurer paid for less than the full amount billed, and Scomed filed five applications for fee review. The Medical Fee Review Section found that no further payment was due and Scomed filed hearing requests thereafter.

The matters were assigned to a Fee Review Hearing Officer, who held an initial hearing where the insurer argued that because Scomed was not a health care provider, the fee review matters should be dismissed. At a second hearing, the insurer expanded on their motion to dismiss citing the Commonwealth Court’s prior decision in Harburg Medical Sales Company v. PMA Management Corporation (Pa. Cmwlth., No. 635 C.D. 2020; filed August 30, 2021(unreported)), wherein the court held that a medical supplies distributor was not a health care provider under the Act because it did not provide health care services. At a third hearing, the insurer submitted documents showing the distinction between a health care provider and a medical supplier.

The hearing officer found that Scomed was not a health care provider as defined by Section 109 of the Act, and denied the hearing requests. Scomed appealed to the Commonwealth Court, which affirmed the Hearing Officer. The court rejected Scomed’s argument that the Act defines health care providers broadly, and should be construed to include durable medical equipment.  The court noted that Section 109 of the Act, and the Medical Cost Containment Regulations, describe entities that are licensed by the Commonwealth to provide health care services, and that Scomed primarily sells or distributes medical goods, not services. According to the court, Scomed has nothing to do with treatment, and simply dispenses a product.