10.08.26
On October 6, 2026, the Pennsylvania Supreme Court denied a Petition for Allocator filed by Scomed Supply, rendering the Commonwealth Court’s Decision confirming that Scomed is not a “healthcare provider” within the meaning of the Pennsylvania Workers’ Compensation Act (“the Act”) a final decision.
This case began as an Application for Fee Review filed by Scomed Supply, a supplier of durable medical equipment. Scomed supplied to an injured worker a TENS unit prescribed by the treating physician for treatment of the work injury, along with items such as electrodes, batteries, lead wires, moisturizer and alcohol wipes. The carrier repriced Scomed’s submitted bills and paid a reduced amount. Scomed filed an Application for Fee Review pursuant to Section 306 (f.1)(5) of the Act. The Bureau’s Medical Fee Review Section found that no further payments were due to Scomed. Scomed filed a Request for Hearing to Contest Fee Review. In a Decision circulated on January 2, 2025, Hearing Officer Pickens denied Scomed’s Petitions, finding that Scomed was not a healthcare provider under the Act and its regulations. Scomed filed an appeal to the Pennsylvania Commonwealth Court, alleging that Hearing Officer Pickens erred in her Decision.
The Commonwealth Court’s March 16, 2026 decision (355 A.3d 456 (Pa. Cmwlth. 2026)), affirmed, confirming that Scomed was not a healthcare provider under the provisions of the Act and its regulations. The Court noted that the term “healthcare provider” is defined in both Section 109 of the Act, as well as the Medical Cost Containment Regulations 127.3(a). While those two definitions differed somewhat, the Court found that the definitions were clear and unambiguous, and did not include the type of supplies which Scomed dispensed. The Court declined to broaden the definition of healthcare provider to include medical suppliers, consistent with prior decisions. It further distinguished this situation from the Court’s holding in Schmidt v. Schmidt Kirifides & Rassias PC (WCAB), 333 A.3d 310 (Pa. 2025), and did not find that the Schmidt case required including Scomed as a healthcare provider under the Act. The Court rejected Scomed’s public policy argument that failure to allow medical suppliers to file Fee Reviews would deprive injured workers of quality medical care.
Medical suppliers such as Scomed can no longer utilize the fee review procedures under Section 306(f.1)(5) of the Act to challenge the timeliness or amount of payment by insurance carriers. That being said, an aggrieved medical supplier might resort to filing lawsuits in Common Pleas Court, seeking similar relief denied to them under the WC system by this ruling. It is untested how Common Pleas Courts across the state would handle such lawsuits. Typically, that could depend on the judge assigned. Some judges will take the position that they lack jurisdiction to hear such cases which are governed by the Pennsylvania Workers’ Compensation Act, while others may allow the case to be adjudicated, possibly costing more to the carrier than paying the disputed charges.
In terms of Fee Review Applications and Requests for Hearing to Contest Fee Reviews, any organization that has pending petitions that are similar should request that they be dismissed by the Bureau and Fee Review Hearing Officers based on this Decision. Also, insurers/employers can choose to use this Decision to negotiate any disputes on payments directly with Scomed, in order to reduce the risk and costs of a potential Common Pleas lawsuit, using the leverage provided to us by the Court.
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