Thursday, May 08, 2003

Commonwealth Court Publishes Opinion on Disposition of Penalties for Late Reimbursement of Blue Cross

In Westinghouse Electric Corp. v. WCAB (Weaver) the Commonwealth Court denied a laundry list of Employer arguments surrounding what penalties are due when the employer is late in reimbursing Highmark Blue Cross and to whom the penalties are paid. The penalties are payable to the Claimant. Penalties are payable: 1) On bills Ordered to be reimbursed by the WCJ, regardless of whether LIBC-9 or HCFA forms were provided; 2) Without regard to Highmark's agreement to waive penalties for a period of time; 3) On amounts found on the Explanation of Benefits forms even though the accident lien report showed different numbers; 4) On the difference when Highmark's reimbursement was less than the Act 44 repriced amount; and 5) On the Claimant's deductible. The Court further rejected the Employer's argument that no penalties are payable because the Claimant received no award on amounts payable to Highmark. The Claimant did receive indemnity and medical benefits for the injury.

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