[J-23-2024]

IN THE SUPREME COURT OF PENNSYLVANIA

WESTERN DISTRICT

ELITE CARE, RX, LLC

v.

PREMIER COMP SOLUTIONS, LLC; 

LAUNDRY OWNERS’ MUTUAL LIABILITY 

INSURANCE ASSOCIATION; UPMC 

BENEFIT MANAGEMENT SERVICES, INC. 

D/B/A UPMC WORK PARTNERS; 

LACKAWANNA CASUALTY COMPANY; 

AND BRICK STREET MUTUAL 

INSURANCE COMPANY

APPEAL OF: PREMIER COMP 

SOLUTIONS, LLC AND BRICK STREET 

MUTUAL INSURANCE COMPANY

:

:

:

:

:

:

:

:

:

:

:

:

:

:

:

:

No. 25 WAP 2023

Appeal from the Order of the 

Superior Court entered May 23, 

2023 at No. 1144 WDA 2020, 

affirming the Order of the Court of 

Common Pleas of Allegheny County 

entered June 5, 2020 at No. GD-19-

005312 and remanding.

ARGUED: April 9, 2024

OPINION IN SUPPORT OF REVERSAL

JUSTICE WECHT DECIDED: JULY 17, 2024

The Superior Court below affirmed a decision allowing a lawsuit for fraud, civil 

conspiracy, and unjust enrichment to proceed against workers’ compensation insurance 

carriers that allegedly failed to reimburse providers for medications dispensed to injured 

workers. As I detail below, that holding plainly conflicts with the Workers’ Compensation 

Act’s exclusive remedy provision and was based upon a misunderstanding of the Act’s

fee review provision. The Superior Court’s decision should be reversed.
[J-23-2024] - 2

I. Statutory Background

Under the Workers’ Compensation Act, employers and their insurers are liable for 

a claimant’s reasonable medical expenses, which includes medication and medical 

supplies.1 Generally speaking, disputes about medical expenses can be litigated three 

different ways within the workers’ compensation system: utilization review, penalty 

petitions, and fee review.

Utilization review can be used by employers to challenge the reasonableness or 

necessity of a billed service, or by providers to secure pre-approval from the insurer for a 

medical service.2 When a request for utilization review is made, an impartial “provider 

licensed in the same profession and having the same or similar specialty as that of the 

provider of the treatment under review” will consider the reasonableness and necessity 

of the treatment and render a decision.3 A party who disagrees with the outcome of the 

utilization review can appeal the determination to a Workers’ Compensation Judge, and 

then eventually to the Commonwealth Court as well.

4

Penalty petitions arise in a different context. A claimant who believes that their

employer has failed to satisfy its statutory obligation to pay necessary medical expenses

can file a penalty petition, which will then be decided by a WCJ. Unlike utilization review, 

which medical providers can initiate themselves, it is only the claimant that can file a 

penalty petition. This avenue therefore may be of limited utility to medical providers 

1 77 P.S. § 531(1)(i) (“The employer shall provide payment in accordance with this 

section for reasonable surgical and medical services, services rendered by physicians or 

other health care providers, including an additional opinion when invasive surgery may 

be necessary, medicines and supplies, as and when needed.”).

2 77 P.S. § 531(6).

3

Id. § 531(6)(i).

4

Id. § 531(6)(iv).
[J-23-2024] - 3

whenever the claimant is unmotivated to file a penalty petition against their employer for 

one reason or another.

5

Fee review is the third avenue for billing challenges. Under a provision of the Act 

passed in 1993, providers can challenge the “amount or timeliness” of the insurer’s 

payment by filing a fee review application. Fee review applications are first decided 

administratively by the Bureau of Workers’ Compensation, but either party can take a de 

novo appeal to a special fee review hearing officer.

6

 The hearing officer’s ruling can then 

be appealed to the Commonwealth Court. This process is governed by Subsection 

306(f.1)(5) of the Act, which states that

[a] provider who has submitted the reports and bills required by this section 

and who disputes the amount or timeliness of the payment from the 

employer or insurer shall file an application for fee review with the 

department no more than thirty (30) days following notification of a disputed 

treatment or ninety (90) days following the original billing date of treatment.7

5 One could imagine reasons why a claimant who is receiving wage-loss benefits 

under the Act might be reluctant to initiate adversarial proceedings against their employer 

primarily for the benefit of a medical provider. For example, a claimant in an uncontested 

case who is in the process of negotiating a settlement with their employer might opt to 

forego seeking penalties. A claimant who expects to return to work with their employer 

post-recovery may be similarly apprehensive about filing a penalty petition. That said, 

the Act incentivizes claimants to file penalty petitions by imposing monetary penalties on 

employers who fail to make required payments—with such penalties being payable to the 

claimant. 77 P.S. § 991(d)(i) (stating that employers may be penalized up to ten percent 

of the amount awarded (or up to fifty percent if the delay was “unreasonable or excessive”)

and that any penalties are “payable to the same persons to whom the compensation is 

payable”).

6

It is my understanding that these fee review hearing officers are sometimes 

(though not always) WCJs wearing different hats. See Prescription Partners, LLC v. 

Bureau of Workers’ Comp. Fee Rev. Hearing Off., No. 2107 C.D. 2014, 2015 WL 

6473394, at *1 (Pa. Commw. July 17, 2015) (Cohn Jubelirer, J., concurring) (noting that 

“the Hearing Officer in the instant matter was a Workers’ Compensation Judge” acting in 

a different capacity).

7 77 P.S. § 531(5).
[J-23-2024] - 4

The Act elsewhere defines a “provider” as a “healthcare provider,” which in turn is 

defined to mean:

any 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.8

This Court has emphasized that fee review is designed to be a simple process with 

“a very narrow scope.”

9 That scope is limited to determining the “relatively simple matters”

of “‘the amount or timeliness’ of an insurer’s payment for a particular treatment.”

10

 This 

means that “an employer’s liability for a claimant’s work injury must be established before

the fee review provisions can come into play.”

11

II. Case Law Interpreting Subsection 306(f.1)(5)

As I detail below, a trio of Commonwealth Court decisions in the mid-2010s 

injected unnecessary confusion into the fee review system. That confusion ultimately 

dissipated in 2019, when the Commonwealth Court, sitting en banc, overruled those three 

earlier decisions. While this should have resolved the matter, the Superior Court below 

opted to embrace the Commonwealth Court’s since-discarded line of precedent, ignoring 

the difficult lessons learned by the Commonwealth Court in the previous decade.

The first of these three erroneous decisions concerned whether a provider billing 

a workers’ compensation insurer was the same entity that rendered the care to the 

8 77 P.S. § 29.

9 Crozer Chester Med. Ctr. v. Dept. of Lab. & Indus., 22 A.3d 189, 196 (Pa. 2011).

10 Id. at 197.

11 Armour Pharmacy v. Bureau of Workers’ Comp. Fee Rev. Hearing Off., 206 A.3d 

660, 666 (Pa. Commw. 2019) (emphasis added).
[J-23-2024] - 5

claimant in the first place. The first-level fee reviewer initially ordered the insurer to pay 

the provider’s bills, but the fee review hearing officer ruled on appeal that the Bureau 

lacked jurisdiction over the dispute because it did not concern the “amount or timeliness”

of payment, but instead concerned whether the provider (an entity called the Physical 

Therapy Institute) was a provider under the Act. On further appeal, the Commonwealth 

Court agreed with the hearing officer, holding that fee review is not the proper forum to 

resolve an entity’s provider status.12

The Commonwealth Court reaffirmed this holding the following year in a case 

involving the same parties. In Physical Therapy Institute, Inc. v. Bureau of Workers’

Compensation Fee Review Hearing Office, 108 A.3d 957 (Pa. Commw. 2015), the 

Institute explicitly asked the court to overturn its 2014 holding. The Institute emphasized 

that, if the court’s ruling stands, all an insurer participating in fee review would have to do 

is assert—whether true or not—that the person or entity submitting the bill is not a provider 

under the act. Under the Commonwealth Court’s interpretation, that mere allegation 

would render the Bureau and the fee review hearing officer jurisdictionless to consider 

the dispute. And because un/underpaid providers lack standing to file penalty petitions 

directly with the WCJ, the provider’s only recourse would be to encourage the claimant to 

seek penalties against their employer.

Declining to overturn the 2014 decision, the court reiterated that whether an entity 

is a provider under the Act is “a question of liability, which is beyond the scope of a fee 

review and must be decided by a Workers’ Compensation Judge.”

13

 As for the argument 

12 Selective Ins. Co. of Am. v. Bureau of Workers’ Compensation Fee Review 

Hearing Off., 86 A.3d 300 (Pa. Commw. 2014) (overruled by Armour Pharmacy, 206 A.3d 

at 660).

13 Physical Therapy Inst., Inc. v. Bureau of Workers’ Compensation Fee Review 

Hearing Off., 108 A.3d 957, 959 (Pa. Commw. 2015).
[J-23-2024] - 6

that the court’s interpretation would allow insurers to undermine the entire fee review 

process just by challenging a biller’s provider status, the court stated that providers still 

have “recourse” inasmuch as claimants always can “file a [penalty] petition to establish 

[an] insurer’s liability.”

14

The third case in this line of precedent, also from 2015, involved a physician who 

was dispensing pain medications from his own office.15 When doing this, the physician 

would “repackage” the medications and assign them new National Drug Codes that

significantly increased the insurer’s reimbursement cost. The physician never billed the 

workers’ compensation insurer directly for the medications; instead, he assigned the 

claims to an entity called Prescription Partners, which then billed the insurer. When the 

insurer refused to pay the full cost of the repackaged drugs, Prescription Partners initiated 

fee review proceedings. The first-level administrative analyst concluded that Prescription 

Partners was not a provider under the Act and therefore lacked standing to initiate fee

review. Prescription Partners then unsuccessfully appealed that determination to a

Hearing Officer.

On further appeal, the Commonwealth Court cited the two cases discussed above 

and reiterated that the Bureau and its fee review hearing officers lack “jurisdiction to 

determine whether an entity is a ‘provider’ of medical services, or simply a billing 

agency.”

16

 The court stated that provider status “is a question of liability, which is beyond 

the scope of a fee review and must be decided by a Workers’ Compensation Judge.”

17

 

In a concurrence, Judge Cohn Jubelirer conceded that the majority “is not incorrect based 

14 Id. at 960.

15 Prescription Partners, LLC, 2015 WL 6473394, at *1.

16 Id. at 3 (quoting Physical Therapy Inst., 108 A.3d at 959).

17 Id.
[J-23-2024] - 7

on existing precedent,” but she nevertheless suggested that “reconsideration of those 

cases appears appropriate.”

18

The Commonwealth Court’s holding in the above cases that the Bureau and its fee 

review hearing officers lack jurisdiction to consider the threshold issue of whether an 

entity is a provider unquestionably conflicts with the legislature’s intent when it created 

the fee review process. As Workers’ Compensation Judge and treatise author David B. 

Torrey has explained:

Under [1993 amendments to the Act], jurisdiction over disputes regarding 

amount and timeliness of payment by carriers to providers was taken away 

from WCJs. In substitution, administrative review was introduced, with any 

appeal de novo to a special hearing officer. The injured worker was not to 

be involved. The idea was to expedite disputes that occur in the program 

when the injured worker is not involved, but where, instead, the dispute is 

only a technical one regarding the correct amount to be reimbursed. And, 

of course, the Act mandates that all providers who treat workers’

compensation claimants are bound by the provisions of the Act; the law 

prohibits providers from direct-billing and balance-billing injured workers; 

and, generally, providers have no standing to file petitions directly with a 

WCJ to get their bills paid.

A controversy was injected into this system in the wake of three decisions 

(one in 2014 and two in 2015), from the Commonwealth Court restricting 

the Fee Review Hearing Officer to deciding only issues of the amount and 

timeliness of bills. Via these rulings, the Hearing Officer was prohibited from 

determining the basic issue of standing. In turn, this left two entities—one 

a billing agent, and the other a claim assignee—without recourse in the fee 

review system to complain of unsatisfactory payment, until a WCJ resolved 

any challenge to the entity’s identity as a “provider.”

An irony was thus created under the Pennsylvania practice: the 1993 reform 

forces physicians and other providers to work within the system (no direct 

billing of the injured worker, for example, is permitted), but then left at least 

some of them without an effective, cost-efficient remedy to secure payment. 

In a further irony, the solution was for the provider to encourage the injured 

worker, who was intended to be left out of the controversy, to file a petition 

with a WCJ in the conventional track of litigation.

18 Id. at *5 (Cohn Jubelirer, J., concurring).
[J-23-2024] - 8

Critics of the regime created by these cases complained that provider 

“payment can be stymied by carrier/employer pretextually denying 

causation and the fact that the party seeking relief is in fact a ‘provider.’” R. 

Burke McLemore, a leading critic of this school, admonished, “By the simple 

expedient of denying either causation or status as a provider, a 

carrier/employer can completely thwart reimbursement to a provider of 

legitimate bills—and then go ahead and settle the case with (or without) any 

admission of liability and leaving the provider hanging and without any 

effective remedy.”

19

Fortunately, the Commonwealth Court overruled this line of precedent in 2019. In 

Armour Pharmacy v. Bureau of Workers’ Comp. Fee Review Hearing Office, 206 A.3d 

660 (Pa. Commw. 2019), the Commonwealth Court held that “where the employer 

challenges a fee determination of the Medical Fee Review Section for the stated reason 

that the medical service was not rendered by a ‘provider’ within the meaning of the Act, 

that threshold question must be decided by the Hearing Office.”

20

 The court nevertheless 

cautioned that its holding does not “expand the scope of the fee review proceeding 

beyond timeliness and amount owed to a provider that has treated a claimant for his work 

injury.”

21

 The decision in Armour Pharmacy was never appealed to this Court.

III. The Decision Below

This appeal concerns prescriptions that injured employees had filled by a homedelivery pharmacy called Patient Direct RX. Behind the scenes, Patient Direct does not 

operate as a typical pharmacy would. When Patient Direct fills an injured workers’

prescription, it does not simply bill the workers’ compensation insurance carrier for the 

19 DAVID B. TORREY & ANDREW E. GREENBERG, WORKERS’ COMPENSATION: LAW AND 

PRACTICE § 9:157 (West 2022) (emphasis in original; footnotes omitted).

20 Armour Pharmacy, 206 A.3d at 670.

21 Id. (“This holding does not allow the Hearing Office to determine the 

reasonableness of the medical care or service; the claimant’s injury as work-related; or 

the employer’s liability for a work injury.”).
[J-23-2024] - 9

medication; instead, it sells to the treating physician who wrote the prescription in the first

place the right to bill the workers’ compensation insurer.

Appellee Elite Care, RX, LLC is a billing agent for some of the medical providers 

who purchased claims from Patient Direct RX. When Elite Care tried to collect payment 

on behalf of its providers, the appellant Insurers took the position that Elite Care is not a 

provider under the Act and refused payment. In total, Insurers denied payment for 110 

different injured employees’ medications, resulting in $548,035.28 in unpaid 

prescriptions. When Elite Care’s invoices went unpaid, it initiated many separate feereview proceedings with the Bureau. The Bureau ruled in favor of Elite Care in some of 

the cases, and the Insurers appealed some of those decisions to fee review hearing 

officers, arguing that the Bureau lacked jurisdiction to determine Elite Care’s status as a 

provider. The hearing officers agreed with Insurers that the Bureau lacked jurisdiction

over Elite Care’s fee review applications.

Elite Care did not appeal those adverse decisions to the Commonwealth Court. 

Instead, Elite Care filed a civil lawsuit against Insurers alleging fraud, civil conspiracy, and 

unjust enrichment. Elite Care also sought a declaratory judgment that it is a provider 

under the Act. Insurers filed preliminary objections asserting the trial court lacked subjectmatter jurisdiction over the dispute because Elite Care’s exclusive remedy lies in the 

workers’ compensation system. The trial court overruled Insurers’ preliminary objections, 

reasoning that the case is not a workers’ compensation case but rather a claim for 

damages arising from Insurers’ alleged fraud and conspiracy.22 A three-judge panel of 

22 Trial Court Opinion, 12/28/2020, at 2 (“This case is not a workers’ compensation 

matter. It is a declaratory judgment and damages case alleging that insurers and their 

administrator engaged in fraud and civil conspiracy by refusing to pay Elite [Care] money 

it is owed for medicine supplied to certain insured persons. Such a case is within the 

jurisdiction of this court.”).
[J-23-2024] - 10

the Superior Court unanimously affirmed the trial court and Insurers then successfully 

petitioned for en banc review.23

The en banc court affirmed the trial court, offering essentially three rationales for 

its decision24 First, the court noted that “Elite Care’s three common-law causes of action 

clearly predate the [Workers’ Compensation Act] and have been under the subject-matter 

jurisdiction of the courts of common pleas since time immemorial.”

25

 Second, the court 

emphasized that there is “nothing in the current Workers’ Compensation Act granting the 

Bureau jurisdiction over” the kinds of tort claims that Elite Care alleged in its complaint.26 

Lastly, the panel declined to follow Armour Pharmacy, accusing Commonwealth Court in 

that case of “manufacturing” an “administrative proceeding for a putative provider to seek 

redress within the Bureau.”

27

 Criticizing the Armour Pharmacy Court for what it called 

“legislating from the bench,” the majority opined that the Commonwealth Court created:

an administrative proceeding for putative providers by bestowing a [sic] 

jurisdiction upon Bureau Hearing Officers. That proceeding and jurisdiction 

cannot be found in the language of the [Workers’ Compensation Act]. 

Therefore, we decline to follow Armour Pharmacy, in so far as it stands for 

the proposition that Elite Care may or should have sought redress within the 

Bureau.

Simply stated, the Worker’s Compensation Act does not provide for an 

administrative proceeding by or against putative providers or their billing 

agents in the Bureau. Such entities have no standing there, because the 

[Act] does not confer it upon them. That statute has not divested the original 

23 See Elite Care, Rx, LLC v. Premier Comp Solutions, LLC, 2022 WL 420030 (Pa. 

Super. 2022).

24 Elite Care, Rx, LLC v. Premier Comp Solutions, LLC, 296 A.3d 29 (Pa. Super. 

2023).

25 Id. at 33.

26 Id.

27 Id.
[J-23-2024] - 11

jurisdiction of the courts of common pleas over matters such as the instant 

lawsuit.28

IV. Discussion

The decision below plainly conflicts with the Workers’ Compensation Act’s 

exclusive remedy provision, which this Court has held “extends to [the] workers’

compensation insurance carrier, protecting the insurer to the full extent of the employer’s 

protection.”

29 Because the employer/insurer’s obligation to pay the claimant’s medical 

expenses arises from the Workers’ Compensation Act in the first place, the workers’

compensation system is the exclusive forum for resolving both payment disputes and 

alleged mismanagement of workers’ compensation claims.30 

The Superior Court’s rationale for departing from this well-established rule is

unpersuasive. The panel first reasoned that “Elite Care’s three common-law causes of 

action” are cognizable in the trial court because the tort claims in question “predate” the 

1915 Workers’ Compensation Act “and have been under the subject-matter jurisdiction of 

the courts of common pleas since time immemorial.”

31

 Even Elite Care does not embrace 

this legal theory. There is no support whatsoever for the idea that whether a tort claim is 

barred by the exclusive remedy provision turns on whether the tort in question predates 

the 1915 Workers’ Compensation Act. To the extent that the court believed that the 

28 Id. at 34.

29 Kuney v. PMA Ins. Co., 578 A.2d 1285, 1286 (Pa. 1990) (“An employer’s liability 

for work-related injuries is governed solely by the [Workers’] Compensation Act, and the 

same is true of a compensation insurance carrier.”); see 77 P.S. § 481(a) (“The liability of 

an employer under this act shall be exclusive and in place of any and all other liability to 

such employes, his legal representative, husband or wife, parents, dependents, next of 

kin or anyone otherwise entitled to damages in any action at law or otherwise on account 

of any [compensable] injury or death[.]” (footnote omitted)).

30 Kuney, 578 A.2d at 1286.

31 Elite Care, Rx, 296 A.3d at 33.
[J-23-2024] - 12

General Assembly only intended to bar civil suits for torts created after the enactment of 

the Workers’ Compensation Act, the panel was simply mistaken.

The court further underscored that “nothing in the current Workers’ Compensation 

Act grant[s] the Bureau jurisdiction over” the specific common-law torts alleged in Elite 

Care’s complaint.32 But that proves nothing. The reason why the Act does not give the 

Bureau jurisdiction over claims of fraud and unjust enrichment against employers/insurers 

in connection with their handling of workers’ compensation claims is simple: employers 

and insurers have been given immunity from such claims in exchange for accepting the 

remedies and obligations established in the Act.33 The absence of a statutory provision 

giving the workers’ compensation authorities jurisdiction over a specific set of claims does 

not mean that the General Assembly intended for those claims to proceed in the trial 

court. Indeed, there is nothing in the Act granting the workers’ compensation authorities 

jurisdiction over claims of negligence against employers. But that is not evidence that the 

legislature intended for trial courts to hear negligence suits against employers; it is the 

result of employers being immune from employee negligence suits.

That leaves only the Superior Court’s theory that the exclusive remedy provision 

does not bar Elite Care’s civil suit because the Workers’ Compensation Act only allows 

providers (not putative providers) to seek administrative fee review. Of course, the 

Commonwealth Court in Armour Pharmacy held that the Bureau does have jurisdiction to 

decide provider status. And I have little doubt that Armour Pharmacy—at least broadly 

speaking—was correctly decided. The Act’s fee-review provision merely states that “a 

provider . . . who disputes the amount or timeliness of the payment from the employer or 

32 Id.

33 Kuney, 578 A.2d at 1286.
[J-23-2024] - 13

insurer shall file an application for fee review with the department.”

34

 While the statute 

plainly limits participation in the fee review process to providers, it does not explicitly 

preclude the Bureau from deciding the threshold issue of an applicant’s provider status. 

The restriction is a judicial invention. Furthermore, to the extent that the statute is 

ambiguous regarding the Bureau’s authority to decide whether a putative provider is in 

fact a provider, the Superior Court’s chosen interpretation undoubtedly conflicts with the 

legislature’s intent, which was to create an expedited fee-review process within the 

workers’ compensation system that does not require the involvement of claimants.35

To my mind, the only objectionable aspect of the Armour Pharmacy decision is

that it allows only fee review hearing officers to resolve challenges to a billing entity’s 

provider status, meaning that first-level administrative reviewers cannot consider the 

issue in the first instance.

36

 I concede that this piece of the Commonwealth Court’s 

decision is not grounded in any statutory text and appears to be driven primarily by the 

concern that those conducting the initial administrative review often lack legal training.37 

34 77 P.S. § 531(5).

35 See DAVID B. TORREY & ANDREW E. GREENBERG, WORKERS’ COMPENSATION: LAW 

AND PRACTICE § 9:157 (West 2022) (highlighting the irony that the Commonwealth Court’s 

pre-Armour Pharmacy decisions left some putative providers “without an effective, costefficient remedy to secure payment” while insisting that “the solution was for the provider 

to encourage the injured worker, who was intended to be left out of the controversy, to 

file a petition with a WCJ in the conventional track of litigation” (emphasis omitted)).

36 See Armour Pharmacy, 206 A.3d at 670 (“We hold that where the employer 

challenges a fee determination of the Medical Fee Review Section for the stated reason 

that the medical service was not rendered by a ‘provider’ within the meaning of the Act, 

that threshold question must be decided by the Hearing Office. Jurisdiction, a quasijudicial matter, is not to be decided by the Medical Fee Review Section, whose 

responsibility is solely administrative.”).

37 See generally Crozer Chester Med. Ctr., 22 A.3d at 196 (explaining that the fee 

review process “is administered by nurses” whose “skills are markedly distinct from” those 

of workers’ compensation judges).
[J-23-2024] - 14

It is this part of Armour Pharmacy that I believe prompted the court below to accuse the 

Commonwealth Court of “legislat[ing] from the bench.”

38

 Regardless, this Court need not 

adopt Armour Pharmacy’s reasoning in toto to conclude that the Superior Court erred 

below. It is enough to say that Armour Pharmacy was correct in abandoning the notion 

that provider status “is a question of liability, which is beyond the scope of a fee review 

and must be decided by a Workers’ Compensation Judge.”

39

 Whether challenges to an 

entity’s provider status should be resolved in the first or the second level of the fee review 

process is irrelevant. It is enough for our purposes today to say that nothing in the Act 

prevents the issue of a putative provider’s standing from being resolved in fee review. 

The Superior Court therefore erred in holding that the Act “does not provide for an 

administrative proceeding by or against putative providers or their billing agents in the 

Bureau.”

40

In sum, the decision below misinterpreted Subsection 306(f.1)(5) and created a 

state of affairs that plainly conflicts with the Act’s exclusive remedy provision. Elite Care’s 

sole remedy lies in the administrative realm. The lower courts therefore erred in allowing

Elite Care’s civil suit to proceed.

I would reverse the Superior Court’s decision.

Justice Brobson joins this opinion in support of reversal. 

38 See Elite Care, Rx, LLC, 296 A.3d at 34 (accusing the Armour Pharmacy Court of 

creating “an administrative proceeding for putative providers” that “cannot be found in the 

language of the [Act]”).

39 Prescription Partners, LLC, 2015 WL 6473394, at *3.

40 Elite Care, Rx, LLC, 296 A.3d at 34 (stating that the Act “does not provide for an 

administrative proceeding by or against putative providers or their billing agents in the 

Bureau,” meaning that the statute “has not divested the original jurisdiction of the courts 

of common pleas” over actions brought by putative providers).