IN THE COMMONWEALTH COURT OF PENNSYLVANIA

700 Pharmacy, :

Petitioner :

:

v. : No. 1190 C.D. 2018

: Submitted: June 28, 2019

Bureau of Workers' Compensation :

Fee Review Hearing Office :

(Workers' Compensation Security :

Fund), :

Respondent :

BEFORE: HONORABLE MARY HANNAH LEAVITT, President Judge

HONORABLE RENÉE COHN JUBELIRER, Judge

HONORABLE CHRISTINE FIZZANO CANNON, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION 

BY PRESIDENT JUDGE LEAVITT FILED: September 9, 2019

700 Pharmacy (Pharmacy) petitions for review of an adjudication of the 

Bureau of Workers’ Compensation, Fee Review Hearing Office (Hearing Office) 

that dismissed Pharmacy’s two fee review applications for the stated reason that the 

Hearing Office lacked jurisdiction to determine whether Pharmacy was a “provider” 

under the Pennsylvania Workers’ Compensation Act (Act).1 Pharmacy argues the 

Hearing Office’s adjudication has left it without a forum to challenge the Workers’ 

Compensation Security Fund’s (Security Fund)2refusal to reimburse it for 

medications it dispensed to a workers’ compensation claimant, and this violates due 

 

1 Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§1-1041.4, 2501-2710.

2 Established under the Workers’ Compensation Security Fund Act, Act of July 1, 1937, P.L. 2532, 

as amended, 77 P.S. §§1051-1066, the Security Fund was created “for the purpose of assuring to 

persons entitled thereto the compensation provided by the Work[ers’] Compensation Law for 

employments insured in insolvent stock companies; insolvent mutual carriers; insolvent reciprocal 

exchanges; or the State Work[ers’] Insurance Fund.” Section 3 of the Workers’ Compensation 

Security Fund Act, 77 P.S. §1053.
2

process. Concluding this matter is controlled by our recent decision in Armour 

Pharmacy v. Bureau of Workers’ Compensation Fee Review Hearing Office 

(Wegman’s Food Markets, Inc.), 206 A.3d 660 (Pa. Cmwlth. 2019), we reverse and 

remand.

Elaine Roberts (Claimant) sustained a work injury on September 29, 

1989, and receives compensation benefits from the Security Fund. On September

11, 2017, Miteswar Purewal, M.D., prescribed several medications to treat claimant 

for her work injury. Pharmacy dispensed the medications on September 11, 2017, 

and January 5, 2018, and submitted two invoices to the Security Fund. The first 

invoice sought payment of $663.66, and the second sought payment of $619.73. The 

Security Fund denied payment of the invoices for the stated reason that Dr. Purewal 

has a 12.25% ownership interest in Pharmacy, in violation of Section 306(f.1)(3)(iii) 

of the Act.3 Pharmacy filed two fee review applications with the Bureau’s Medical 

Fee Review Section, which referred them to the Hearing Office for an adjudication.

On April 4, 2018, the hearing began. The Security Fund stated that 

Pharmacy’s fee applications should be dismissed because Pharmacy was not a 

 

3 Section 306(f.1)(3)(iii) of the Act provides:

Notwithstanding any other provision of law, it is unlawful for a provider to refer a 

person for laboratory, physical therapy, rehabilitation, chiropractic, radiation 

oncology, psychometric, home infusion therapy or diagnostic imaging, goods or 

services pursuant to this section if the provider has a financial interest with the 

person or in the entity that receives the referral. It is unlawful for a provider to 

enter into an arrangement or scheme such as a cross-referral arrangement, which 

the provider knows or should know has a principal purpose of assuring referrals by 

the provider to a particular entity which, if the provider directly made referrals to 

such entity, would be in violation of this section. No claim for payment shall be 

presented by an entity to any individual, third-party payer or other entity for a 

service furnished pursuant to a referral prohibited under this section. 

77 P.S. §531(3)(iii) (emphasis added).
3

“provider” within the meaning of the Act.4 Section 109 of the Act defines a “[h]ealth 

care provider” as follows:

[A]ny person, corporation, facility or institution licensed or 

otherwise authorized by the Commonwealth to provide health 

care services, including, but not limited to, any physician, 

coordinated care organization, hospital, health care facility, 

dentist, nurse, optometrist, podiatrist, physical therapist, 

psychologist, chiropractor or pharmacist and an officer, employe 

or agent of such person acting in the course and scope of 

employment or agency related to health care services.

77 P.S. §29. The Security Fund asserted Pharmacy was not a provider, but, rather,

was “a front, along with a chain of other similar shell companies, for a separate 

company known as Inductions Works[.]” Security Fund’s Brief at 6.

The Hearing Office ordered briefs on the issue of jurisdiction. On 

August 8, 2018, relying on this Court’s decision in Selective Insurance Company of 

America v. Bureau of Workers’ Compensation Fee Review Hearing Office (The 

Physical Therapy Institute), 86 A.3d 300 (Pa. Cmwlth. 2014), the Hearing Office 

held that a Workers’ Compensation Judge must decide whether Pharmacy is a 

“provider” as defined by the Act. Accordingly, the Hearing Office dismissed the fee 

review applications as premature.

Pharmacy petitioned for this Court’s review.

5

 On appeal, Pharmacy 

argues that it will not receive a hearing on the Security Fund’s refusal to pay for 

 

4 Section 306(f.1)(1)(i) of the Act requires an employer to pay for “reasonable surgical and medical 

services, services rendered by physicians or other health care providers ... medicines and supplies, 

as and when needed.” 77 P.S. §531(1)(i). Section 306(f.1)(5) of the Act allows a “provider who ... 

disputes the amount or timeliness of [a] payment from the employer or insurer” to file an 

application for fee review. 77 P.S. §531(5).

5 This Court’s review of a decision by the Hearing Office determines whether the necessary 

findings of fact are supported by substantial evidence, whether constitutional rights were violated,
4

Claimant’s treatment unless Claimant agrees to pursue litigation. Pharmacy argues 

that a procedure that requires a litigant to obtain a third party’s permission to protect 

its property rights violates due process.

6

 

In Armour Pharmacy, 206 A.3d at 664, the Hearing Office dismissed 

the employer’s challenge to a fee determination for the stated reason that the Hearing 

Office lacked jurisdiction to decide whether Armour Pharmacy was a provider 

within the meaning of the Act. This Court reversed, holding that the Hearing Office 

has jurisdiction to determine the threshold question of whether an entity is a 

“provider” under the Act. Id. at 671. Accordingly, this Court reversed the Hearing 

Office’s dismissal of Armour Pharmacy’s fee application. 

Armour Pharmacy is dispositive. Accordingly, as in Armour 

Pharmacy, we reverse the Hearing Office’s adjudication and remand for a 

determination of whether Pharmacy is a “provider” within the meaning of Section 

109 of the Act, 77 P.S. §29.

7

 _____________________________________

 MARY HANNAH LEAVITT, President Judge

 

and whether the Hearing Office committed an error of law. 2 Pa. C.S. §704; Walsh v. Bureau of 

Workers’ Compensation Fee Review Hearing Office (Traveler’s Insurance Co.), 67 A.3d 117, 120 

n.5 (Pa. Cmwlth. 2013). Regarding questions of law, our scope of review is plenary and our 

standard of review is de novo. Sedgwick Claims Management Services, Inc. v. Bureau of Workers’ 

Compensation, Fee Review Hearing Office (Piszel and Bucks County Pain Center), 185 A.3d 429, 

433 n.2 (Pa. Cmwlth. 2018).

6 The Due Process Clause of the Fourteenth Amendment states as follows:

No State shall make or enforce any law which shall abridge the privileges or 

immunities of citizens of the United States; nor shall any State deprive any person 

of life, liberty, or property, without due process of law; nor deny to any person 

within its jurisdiction the equal protection of the laws. 

U.S. CONST. amend. XIV, §1. The Pennsylvania Constitution also provides this protection. PA.

CONST. art. I, §9.

7

If the Hearing Office finds Pharmacy is a provider, the outstanding issue regarding whether 

improper self-referral occurred must then be addressed. 
IN THE COMMONWEALTH COURT OF PENNSYLVANIA

700 Pharmacy, :

Petitioner :

:

v. : No. 1190 C.D. 2018

:

Bureau of Workers' Compensation :

Fee Review Hearing Office :

(Workers' Compensation Security :

Fund), :

Respondent :

O R D E R

AND NOW, this 9th day of September, 2019, the order of the Bureau of 

Workers’ Compensation Fee Review Hearing Office, dated August 8, 2018, is 

hereby REVERSED and this matter is REMANDED for further proceedings in 

accordance with the attached opinion.

Jurisdiction relinquished.

 _____________________________________

 MARY HANNAH LEAVITT, President Judge