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Workers' Compensation

Medical Providers Cannot Bring Suit in Civil Court for MO WC Medical Fee Disputes

The Missouri Court of Appeals, Eastern District, issued an opinion on July 25, 2023 holding that any disputes from a medical provider relating to payment for treatment rendered in a workers’ compensation case may only be brought as a Medical Fee Dispute under R.S.Mo. 287.140. Orthopedic Ambulatory Surgery Center of Chesterfield, LLC v. Sharpe Holdings, Inc. et al, No. ED 110859, July 25, 2023. In this case, two medical providers in St. Louis filed 26 cases against various employers related to medical fee disputes.

MVP Attorneys Greg Cook and Spencer Low participated in, and briefed, the case on behalf of some of the 26 employers. In all but two cases, the providers had filed a Medical Fee Dispute under the Workers’ Compensation Act, but did so outside the statute of limitations, and the Disputes were denied. The medical providers initiated civil litigation in St. Louis County, claiming that providers should be able to choose whether to initiate a civil action or a Medical Fee Dispute. Summary Judgment was granted in the employers’ favor and the medical providers appealed to the Court of Appeals, Eastern District, which affirmed summary judgment for employers.

The Court of Appeals’ decision establishes that the Missouri Workers’ Compensation Act is the sole avenue to bring Medical Fee Disputes related to treatment in any workers’ compensation case. Medical providers cannot bring an action in civil court and instead are bound by R.S.Mo. 287.140 to file a Medical Fee Dispute with the Division of Workers’ Compensation.

To read the court’s decision in Orthopedic Ambulatory Surgery Center of Chesterfield LLC v. Share Holdings Inc., No. ED110859, 07/25/2023, published, click here.

If you have additional questions about medical fee disputes in Missouri, please contact Greg Cook, Spencer Low, or Josh Mareschal