IN THE COMMONWEALTH COURT OF PENNSYLVANIA

700 Pharmacy, : CASES CONSOLIDATED

Petitioner :

 :

v. : No. 562 C.D. 2020

 : 

Bureau of Workers’ Compensation :

Fee Review Hearing Office (State :

Workers’ Insurance Fund), :

Respondent :

State Workers’ Insurance Fund, :

Petitioner :

:

v. : No. 612 C.D. 2020

: Argued: April 9, 2024

Bureau of Workers’ Compensation Fee :

Review Hearing Office (700 Pharmacy), :

Respondent :

BEFORE: HONORABLE RENÉE COHN JUBELIRER, President Judge

HONORABLE LORI A. DUMAS, Judge

HONORABLE MATTHEW S. WOLF, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION BY

PRESIDENT JUDGE COHN JUBELIRER FILED: May 16, 2024

In this case, 700 Pharmacy (Pharmacy) and State Workers’ Insurance Fund 

(Insurer) cross-petition for review of the decision and order of Hearing Officer David 

Torrey (Hearing Officer) of the Bureau of Workers’ Compensation Fee Review 

Hearing Office (Bureau) denying and dismissing six fee review applications 

(Applications) Pharmacy brought in connection with prescriptions it filled for a 
2

claimant.1 Insurer argues the Hearing Officer erred in concluding Pharmacy, staffed 

by a pharmacist provided by an employee leasing agency, amounts to a provider as 

defined by Section 109 of the Workers’ Compensation Act (Act),2 77 P.S. § 29, with 

standing to bring a fee review application under Section 306(f.1)(5) of the Act, 77 

1 The Applications at issue involve the following prescriptions and amounts. MF-574610 

involves prescriptions for Zolpidem Tartrate 10-milligram tablets, Dok 100-milligram softgels; 

Ondansetron Hcl 4-milligram tablets, and Oxcarbazepine 300-milligram tablets totaling 

$3,045.02, as well as Hysingla ER 20-milligram tablets and Hydrocodon-Acetaminophen 5-325 

totaling $502.72. (Reproduced Record (R.R.) at 59a-60a.) MF-577911 involves prescriptions for 

Amitriptyline Hcl powder, Diclofenac sodium powder, Baclofen powder, Base Pcca Emulsifix, 

Lidocaine powder, and Hydrocodon-Acetaminophen 5-325, totaling $1,556.43, along with 

Zolpidem Tartrate 10-milligram tablets, Dok 100-milligram softgels, Ondansetron Hcl 4-

milligram tablets, Oxcarbazepine 300-milligram tablets, and Hysingla ER 20-milligram tablets, 

totaling $3,463.06. (Id. at 77a-78a.) MF-579327 involves prescriptions for Oxcarbazepine 300-

milligram tablets, Belbuca 300-microgram films, Hydrocodon-Acetaminophen 5-325, Zolpidem 

Tartrate 10-milligram tablets, Dok 100-milligram softgels, and Ondansetron Hcl 4-milligram 

tablets totaling $3,961.13, as well as Amitriptyline Hcl powder, Diclofenac sodium powder, 

Baclofen powder, Base Pcca Emulsifix 205, and Lidocaine powder totaling $1,496.65. (Id. at 

245a-246a.) MF-580809 involves prescriptions for Amitriptyline Hclpowder, Diclofenac sodium 

powder, Baclofen powder, Base Pcca Emulsifix-205, Lidocaine powder, and Zolpidem Tartrate 

10-milligram tablets, totaling $1,432.01, as well as Dok 100-milligram softgels and Ondansetron 

Hcl 4-milligram tablets totaling $2,668.49. (Id. at 106a-107a.) The Applications related to MF584789 and MF-586128 do not appear in the Reproduced Record but are listed in the Hearing 

Officer’s Decision Rendered Cover Letter. (Hearing Officer Decision at 1.) Medications are listed 

in this footnote as they appear on the forms submitted by Pharmacy found in the Reproduced 

Record.

2 Act of June 2, 1915, P.L. 736, as amended, added by Section 3 of the Act of July 2, 1993, 

P.L. 190, 77 P.S. § 29. More specifically, Section 109 defines “provider” as “health care provider,” 

which in turn is defined as

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.

Id. Accordingly, we use “provider” and “health care provider” interchangeably. 
3

P.S. § 531(5). (Insurer Petition for Review ¶ 9.) Pharmacy argues the Hearing 

Officer erred in concluding the prescriptions forming the basis of the Applications 

were the product of an unlawful self-referral under Section 306(f.1)(3)(iii) of the 

Act, 77 P.S. § 531(3)(iii) (anti-referral provision).3 (Pharmacy Petition for Review 

¶ 8.)

These cross-petitions for review involve the same parties and legal issues as 

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

(State Workers’ Insurance Fund), ___ A.3d ___ (Pa. Cmwlth., Nos. 560 and 617 

C.D. 2020, filed May 16, 2024) (700 Pharmacy I).4 In 700 Pharmacy I, we 

concluded that Pharmacy has standing to request fee review but that the prescriptions 

underlying the applications at issue there were products of a prohibited self-referral 

under the anti-referral provision. Therefore, we affirmed the Hearing Officer’s 

denial and dismissal of those applications. 

3 The anti-referral provision was added by Section 8 of the Act of July 2, 1993, P.L. 190, 

and 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).

4

(See Pharmacy’s Brief (Br.) at 5 n.3 (explaining that five appeals, including 700 

Pharmacy I and the instant matter, “involv[e] the same legal question and involv[e] the same 

parties”); see also Insurer’s Br. at 8 n.1 (same).) 
4

The Hearing Officer’s dispositive findings of fact and conclusions of law in 

this matter are nearly identical to those in 700 Pharmacy I. First, just as in 700 

Pharmacy I, the Hearing Officer in this case found that “[the claimant’s] treating 

pain physician, Dr. Miteswar Purewal, whose office is upstairs from [] Pharmacy, 

wrote or supervised the prescriptions for the medications at issue. In an exhibit of 

[] Pharmacy, [Dr. Purewal] acknowledges that he has a financial interest in [] 

Pharmacy.” (Hearing Officer Decision, Finding of Fact (FOF) ¶ 3; see also 

Reproduced Record at 200a.) Second, the Hearing Officer also found here that 

Induction Works, the employee-leasing team handling billing for Pharmacy, is an 

agent of Pharmacy, such that Pharmacy continues to have standing to pursue the 

Applications. (FOF ¶ 10.) Because there is no relevant factual or legal difference 

between this case and 700 Pharmacy I, we must conclude here, too, that Pharmacy 

had standing to file the Applications, and that the underlying prescriptions are the 

product of a prohibited self-referral, as the anti-referral provision includes 

pharmacies. Accordingly, for the reasons set forth in 700 Pharmacy I, we affirm.

__________________________________________

RENÉE COHN JUBELIRER, President Judge
IN THE COMMONWEALTH COURT OF PENNSYLVANIA

700 Pharmacy, : CASES CONSOLIDATED

Petitioner :

 :

v. : No. 562 C.D. 2020 

 : 

Bureau of Workers’ Compensation :

Fee Review Hearing Office (State :

Workers’ Insurance Fund), :

Respondent :

State Workers’ Insurance Fund, :

Petitioner :

:

v. : No. 612 C.D. 2020

:

Bureau of Workers’ Compensation Fee :

Review Hearing Office (700 Pharmacy), :

Respondent :

O R D E R

NOW, May 16, 2024, the Order of the Bureau of Workers’ Compensation Fee 

Review Hearing Office, in the above-captioned matter, is AFFIRMED.

__________________________________________

RENÉE COHN JUBELIRER, President Judge