A judge banging their gavel on a table The  Elite Care RX case was a dispute between insurers and Elite Care, RX, LLC, a billing agent for some of the medical providers who purchased claims from Patient Direct RX, a home delivery pharmacy. (Credit: utah51/Adobe Stock)

A recent Pennsylvania court case examined whether a medical provider would be allowed to pursue a civil suit against an insurer for unpaid workers' compensation benefits.

In Elite Care RX v. Premier Comp Solutions, No. 25 WAP 2023, the Pennsylvania Supreme Court was asked to address where a health care provider can pursue a claim against an insurer for unpaid medical bills incurred by injured workers receiving workers' compensation benefits. Must a provider go through the administrative processes of Pennsylvania's Workers' Compensation Act (the act), or could it pursue a civil lawsuit?

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