The Commonwealth Court of Pennsylvania issued a decision on March 16, 2026 determining that a retail seller of durable medical equipment and medical supplies does not qualify as a “health care provider” under Section 306(f.1)(5) of the Pennsylvania Workers’ Compensation Act (PA WC Act). In Scomed Supply v. Hartford Accident & Indemnity Company and Sedgwick Claims Management Services, Scomed provided various medical supplies to an injured worker for a TENS unit, which had been prescribed by a treating physician for the work-related injury. The medical supplies included electrodes, batteries, lead wires, alcohol wipes and moisturizer. Scomed billed the workers’ compensation insurance carrier. The insurer paid less than the total billed amount. Scomed filed five Applications for Fee Review with the Bureau. The Bureau determined that insurer did not owe Scomed any additional payments. Scomed filed Requests for Hearing, which were assigned to a Fee Review Hearing Officer.
During the litigation, the insurer argued that Scomed was not a “health care provider” under Section 109 of the PA WC Act and thus, had no recourse to seek Fee Review under Section 306(f.1)(5) of the PA WC Act. Section 109 of the PA WC Act defines a “health care provider” 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, chiropractor or pharmacist and an officer, employee or agent of such person acting in the course and scope of employment or agency related health care services. Scomed argued that Section 109 of the PA WC Act should be broadly interpreted to include durable medical equipment for an injured worker’s TENS unit. Hearing Officer Pickens held that Scomed is not a health care provider as defined by Section 109. Scomed filed an Appeal.
The Commonwealth Court rejected Scomed’s argument and found that Scomed does not provide health care services, but instead, deals with the sale and distribution of medical goods. The Court reasoned that Scomed does not treat an injured worker, but only dispenses a product prescribed by a physician. The Court held that Scomed’s actions do not fall within the coverage of the definition of “health care provider” under Section 109 of the PA WC Act. Therefore, Scomed cannot avail itself to the Fee Review process.
This decision and reasoning by the Commonwealth Court is instructive because it views the involvement of a company, such as Scomed, as only a provider of goods, and not health care services under the PA WC Act. The Court concluded that the plain language of the PA WC Act does not permit an extension of the Fee Review process to a company such as Scomed. This case will provide workers’ compensation insurance carriers with legal authority to defend against Fee Review challenges filed by companies that provide medical supplies but do not health care services, to injured workers. These medical supply companies have no standing to dispute the amount paid by an insurer through the Fee Review Process. Insurers and Defense Counsel can utilize this case law to seek dismissal before a Fee Review Hearing Officer for an improperly filed Request for Hearing by a medical supply company, such as Scomed.
Zachary M. Rubinich is a partner in our Philadelphia office. He focuses his practice on the defense of insurance carriers, self-insured entities and third-party administrators against workers’ compensation claims in Pennsylvania. Based on his extensive experience, the Pennsylvania Bar Association Workers’ Compensation Law Section has certified him as Specialist in the practice of workers’ compensation law Zach has handled all aspects of litigation before workers’ compensation judges, the Workers’ Compensation Appeal Board, the Commonwealth Court and the Pennsylvania Supreme Court. Zach has been appointed to the following American Bar Association Tort Trial and Insurance Practice (TIPS) leadership positions: Past-Chair of the Litigation and Trial Practice Committee; Vice-Chair of the Appellate Advocacy Committee; Member of the Ethics and Professionalism Standing Committee; and Member of the CLE Board Committee. He is the Past-Chair of the ABA’s Tort Trial and Insurance Practice (TIPS) Workers’ Compensation and Employers’ Liability Law Committee from 2018-2019. He has served as a Vice-Chair of this committee from 2015 to present. In addition, Zach served as Vice-Chair of the 2017-2018 American Bar Association Standing Committee for Diversity and Inclusion. He is also a Committee Member of the ABA’s Legal Opportunity Scholarship Fund. Zach has been rated AV Preeminent by Martindale-Hubbell for the fourteenth consecutive year for 2026. He has been selected as a 2019, 2020 and 2021 Pennsylvania Super Lawyer by Super Lawyers. He was selected as a Pennsylvania Rising Star by Super Lawyers from 2010 to 2014. He was selected as an International Advisory Experts (IAE) Award recipient in 2019 for his accomplishments as a workers’ compensation attorney in Pennsylvania. Zach has been selected as a Fellow of the College of Workers’ Compensation Lawyers Class of 2020. Mr. Rubinich has been recognized as a Main Line Today 2023 and 2024 Top Lawyer.
Zach can be reached directly at: (215) 575-4340 • zrubinich@rawle.com
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CHAIR: Claudio J. DiPaolo
PARTNERS: Zachary M. Rubinich; J. Brendan O’Brien; Christian M. Stein; Jennifer Schwartz
OF COUNSEL: James Curry; William Copetas; Anthony Lategano;
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