Commonwealth Court Holds That Medical Providers That Accept Medicare Cannot Seek Additional Payment For Treatment Under the Workers' Compensation Act
In Nickel v. WCAB (Agway Agronomy), No. 719 C.D. 2008, October 22, 2008, the claimant and employer entered into a compromise and release agreement in the context of a claim petition where liability was disputed. Importantly, in the settlement agreement, the employer agreed to pay for the outstanding medical bills that were related to the alleged work injury. Thereafter, the employer filed a fee review which the Commonwealth Court held that it had jurisdiction to do so, because in effect it had accepted liability for their payment. However, the Court also held that the medical provider that was going to be reimbursed for bills by the employer could not seek the higher repricing under the Act after accepting initial payment from Medicaid. Nor can the medical provider seek the difference in the payment from the claimant. In other words, if the medical provider chooses to accept funds from Medicaid, then it cannot seek additional payment under the Workers' Compensation Act.
