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Decision Allows Billing Agent to Pursue Civil Claims Against Carriers

Friday, July 19, 2024 | 0

Billing agents can pursue payments for workers' comp prescriptions outside of the fee-review process, under a recent Pennsylvania Supreme Court decision. The high court on Tuesday published a split decision in Elite Care RX v. Premier Comp Solutions LLC, which leaves in place a Superior Court decision allowing agents to assert civil claims against carriers for refusing to pay. Various injured workers had their prescriptions filled by Patient Direct RX, a home-delivery pharmacy. Patient Direct does not operate as a typical pharmacy in that it does not bill workers’ compensation car...

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