Case Title: Washington Township Fire Dept. v. Beltway Surgery Center

Citation: 

Docket Number: 93S02-1002-EX-115

State: indiana

Court: Indiana Supreme Court

Date: 2010-02-24T00:00:00Z

Document:
ATTORNEYS FOR APPELLANT  
 
 
Doris L. Sweetin 
Jeb A. Crandall 
Brandon G. Milster 
Indianapolis, Indiana 
 
Bryan H. Babb 
Kellie M. Barr 
Indianapolis, Indiana 
 
 
 
ATTORNEYS FOR APPELLEE 
Anthony W. Overholt 
Maggie L. Smith 
Indianapolis, Indiana 
 
Apryle A. Fryer 
Indianapolis, Indiana 
 
ATTORNEY FOR AMICI CURIAE 
Mark D. Gerth 
Indianapolis, Indiana 
______________________________________________________________________________ 
 
In the 
Indiana Supreme Court 
_________________________________ 
No. 93S02-1002-EX-115 
WASHINGTON TOWNSHIP FIRE DEPARTMENT,  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Appellant (Defendant below), 
v. 
BELTWAY SURGERY CENTER, 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Appellee (Plaintiff below). 
_________________________________ 
 
Appeal from the Indiana Worker's Compensation Board, No. P-175616 
_________________________________ 
 
On Transfer from the Indiana Court of Appeals, No. 93A02-0811-EX-1006 
_________________________________ 
 
February 24, 2010 
Per Curiam. 
 
The Court of Appeals held the employer, not the medical provider, has the burden of 
proving whether the charges for medical services provided to an employee exceed the employer's 
liability to pay under the Worker's Compensation Act (the "Act").  See Washington Twp. Fire 
FILED
CLERK
of the supreme court,
court of appeals and
tax court
Feb 24 2010, 1:49 pm
 
 
Dep't v. Beltway Surgery Ctr., 911 N.E.2d 590 (Ind. Ct. App. 2009), reh'g denied.  We agree and 
adopt the opinion of the Court of Appeals.1    
 
Beltway Surgery Center ("Beltway") provided medical services to an employee of the 
Washington Township Fire Department ("Washington Township") and then submitted a bill to  
Washington Township's worker's compensation insurance carrier, Indiana Public Employers Plan 
("IPEP").  IPEP hired a "billing review service," Mednet, to determine whether the charges billed 
fell within Washington Township's "pecuniary liability" under the Act.  See Ind. Code § 22-3-6-
1(f). "Pecuniary liability" is an amount "equal to or less than the charges made by medical 
service providers at the eightieth percentile in the same community for like services or products."  
Id. § 22-3-6-1(j).  On Mednet's recommendation, IPEP paid only part of Beltway's bill.     
 
Beltway filed an application for adjustment of claim with the Worker's Compensation 
Board (the "Board").  The single hearing member ordered Washington Township to pay the 
balance on Beltway's bill.     
 
The full Board affirmed, concluding Washington Township had the burden of proving its 
pecuniary liability to Beltway was less than Beltway's billed charges.  Because the Board found 
Washington Township failed to produce any such evidence, it ordered the Township to pay the 
full balance of Beltway's bill.   
 
The Court of Appeals affirmed and held that where the employer refuses to pay in full a 
medical provider's billed charges, and the medical provider files a claim with the Board and 
establishes its charges for services to an employee, the employer has the burden of proving the 
                                                 
1 The Court of Appeals reached the same result in five unpublished decisions pending before this Court.  Because 
we grant transfer in this case to express our agreement with the Court of Appeals, we find it unnecessary to grant 
transfer in the other decisions.  Simultaneous with this opinion, we are denying transfer in Onward Fire Dep't v. 
Clarian Health Partners, No. 93A02-0811-EX-1007 (Ind. Ct. App. June 24, 2009);  Adecco, Inc. v. Clarian Health 
Partners, No. 93A02-0811-EX-1008 (Ind. Ct. App. June 25, 2009); Morgan County Comm'rs v. Clarian Health 
Partners, No. 93A02-0811-EX-1009 (Ind. Ct. App. June 25, 2009); City of Michigan City v. Mem'l Hosp., No. 
93A02-0811-EX-1010 (Ind. Ct. App. June 24, 2009); and Wayne Twp. Fire Dep't v. Beltway Surgery Ctr., No. 
93A02-0811-EX-1011 (Ind. Ct. App. June 25, 2009).   
 
 
charges exceed the employer's liability under the Act.  Washington Twp. Fire Dep't, 911 N.E.2d 
at 599.  In addition, the Court of Appeals held the Board may require an employer that fails to 
meet this burden to pay the medical provider's full bill.  Id. at 600.  We agree.    
 
We grant transfer, adopt and incorporate by reference the opinion of the Court of Appeals 
pursuant to Indiana Appellate Rule 58(A)(1), and affirm the Board.   
 
Shepard, C.J., and Dickson, Sullivan, Boehm, and Rucker, JJ., concur.