*1 reasons, For these I would affirm the adjudication.
Secretary’s GRIFFITHS,
David Petitioner
v.
WORKERS’ COMPENSATION AP- (SEVEN
PEAL BOARD STARS
FARM, INC.), Respondent Farm, Inc.,
Seven Stars Petitioner Compensation Appeal
Workers’ Board
(Griffiths), Respondent.
Commonwealth Pennsylvania. Court of
Argued Sept. 2004.
Decided Nov. *2 about Jan- disability On or
total benefits. pen- 26, 2001, petitioned for uary Claimant violated Employer that alleged alties and (Act)1 rel- Compensation the Workers’ expenses of medical processing to the ative subsequent a van rental regarding a retrofit included Van accessible. make it wheelchair WCJ, parties stipulated Before the purchased the Van that Claimant $18,000, to make it was retrofitted Van for an additional wheelchair accessible Wilson, pe- Philadelphia, L. $10,000, handling Matthew in the shipping and plus titioner. into evi- Also submitted amount $500. $2,085.09for a wheel- dence was a bill for Katz, Jr., Philadelphia, for S. Charles from December chair accessible van rental respondent. 2000, 20, 2001, 22, January and a bill for COLINS, Judge, President BEFORE: $1,968.00 van for a wheelchair accessible McGINLEY, PELLEGRINI, Judge, 21, 2001, February January rental from FRIEDMAN, Judge, Judge, 19, parties stipulated 2001. The further LEADBETTER, Judge, COHN Employer reimbursed Claimant JUBELIRER, LEAVITT, Judge, and of the conversion eighty of the cost percent Judge. of the van eighty percent rental cost. Judge BY OPINION McGINLEY. that the be- parties agreed The issues (Claimant) David Griffiths seeks review fore the were whether Claimant WCJ Compensation Appeal of the Workers’ for the entire entitled to reimbursement (Board) order that Board’s reversed Van; whether Claim- purchase price (WCJ) Compensation Judge’s
Workers’ ant was entitled to reimbursement Farm, decision that ordered Stars Seven only conversion cost of the Van entire (Employer) pay purchase price Inc. cost; and of the conversion eighty percent 2000 Ford van Claimant’s Windstar to reim- Claimant was entitled whether (Van). time, Employer At the same seeks of the van for the full cost bursement review of the order of the Board reim- only eighty percent rental or decision that ordered affirmed WCJ’s by Employer.2 made bursement of the cost of retro- 100% fitting to make it wheelchair ac- the Van penalty petition granted WCJ the full cost of two months cessible and the full cost and ordered has consolidated van rental. This Court Van, required to for review. petitions the two accessible, and the make it wheelchair assessed 21, 2000, charges. The WCJ also August sustained rental
On pay- interest on all deferred percent ten quadriplegia when he was struck C-5 counsel fees began paying ments and awarded hay. Employer bale wife, Griffiths, 736, amended, re- Claimant’s testified 2. Edith June P.L. Act of rental, purchase of the garding van 1-1041.4, §§ 2501-2626. Van, retrofitting. and the appro- of the van itself is percent wage in the amount of ten of all Here, interest, expense, priate. the additional plus loss benefits with the fee $18,500 reasonable namely, the sum of chargeable against share of dis- Claimant’s [(cost retro- shipping of van and without made the ability compensation. The WCJ *3 (Citations fitting) and footnote omit- ] following conclusions of law: ted). Employer/Carrier responsible 1. The appliances’ Decision, 30, 2002, ‘orthropedic [sic] April Conclu- WCJ’s 306(f.l)(l)(ii). 1-2;
the Act. Section Modifica- Reproduced at sions of Law Nos. 1-3 (R.R.) tions to the van to make wheelchair Record at R7-R8. expense for ‘or-
accessible constitute to the Board and Employer appealed thopedic appliances,’ .... responsible asserted that it was not for the provisions 2. The cost containment and that the purchase price of the Van specifically, the erred when he did not limit Claim- WCJ 306(f.l)(3)(i), charges limits of a [sic] recovery expenses ant’s rental van Here, being provider. health care there eighty conversion costs involved, provider no health care Claim- percent. part The Board affirmed in reimbursement, ant not limited as to in part. respect reversed With to whether may recover the actual cost re- pur- for the responsible quired for conversion of the van for Van, price chase the Board re- .of accessibility, and for wheelchair versed:
rental fees. record, a careful review of the After 3. A reasonable cost to Board has determined WCJ is recoverable under the circum- van concluding [Em- erred Defendant stances this case. ployer] responsible van, [Discussion]: with price Without of the base vehicle. The van itself and, retrofitting accessibility, for wheelchair an orthopedic appliance is not therefore, paraplegic require Claimant is confined to not De- does injury; limit- [Employer] his home due to the work fendant for it.... We ed, if totally precluded, reject distinguish not even as to attempt WCJ’s attention, obtaining medical since this Compensation Petrilla Workmen’s [v. Gas), family had no other vehicles to enable Appeal (People’s Board Natural (Pa.Cmwlth.1997) get appoint- to medical ] Claimant based ments, transportation pro- specific was not financial circum- on Claimant’s by acknowledged, vided the carrier. As the stances. WCJ not claimant’s Petrilla did consider the [Employer] obligation Defendant’s and we do not financial circumstances un- is of no benefit source of the funds that see how the turn, In less the Claimant has van. brings produce used to the van Claimant Griffiths, David other whether orthopedic it within the definition of claimant in similar circumstances can the Common- appliance. dependent upon obtain a van is available that the base wealth Court determined Here, moneys pur- resources. for a of a vehicle that is retrofitted price family from a chase were borrowed not recoverable and we claimant’s use is friend. are bound determination. specific spe- consideration of the Upon 23, 2003, at July (Opinion) presented Opinion, financial circumstances Board cial 4; ..., R.R. at R22. of a reasonable sum payment here correct that Claim Employer is rentals and con- respect to the van With timely preserve raise and costs, ant failed to affirmed: version the Board may not be A constitutional issue issue. that Section determined WCJ appeal to this the first time on raised for 306(f.l)(3)(i) does not limit the amount con goes to the question unless the Court no reimbursement because there was Pook v. stitutionality of a statute. See care involved.... health Commonwealth, Board Auctioneer State record, the After a careful review of the (Pa.Cmwlth. Examiners, 735 A.2d that the WCJ did Board has determined 1999). Here, question does concluding that limits of Sec- not err the Act rather constitutionality of in the inapplicable tion are applica that the Board’s asserts *4 instant matter. Section is in a of his tion of the Act resulted denial providers.... to medical Be- directed the law. equal protection under right transaction did not involve a cause the preserved not before The issue was meaning health care within Board.4 Act, [Employer] Defendant is question there is a whether per- 100 required reimburse Claimant Compensation Ap Petrilla v. Workmen’s renting cent of costs of a van for two Gas), 692 (People’s Natural peal Board making purchased and of months (Pa.Cmwlth.1997) controlling A.2d 623 (Citations van wheelchair accessible. overruled. Section should be omitted). omitted. Footnotes 306(f.1)(1)(i) 531(l)(i), § 77 of the P.S. 5-6; Opinion at R.R. at Both R23-R24. part, employer in provides pertinent “[t]he parties petitioned for review with this in provide payment shall accordance with Court. surgical and this section for reasonable services, by services rendered medical I. Petition for Review. Claimant’s providers, or other health care physicians inva opinion an additional when including Claimant contends that the Board’s de- necessary, required may termination that be medicines surgery sive purchase price of the vio- as and when needed.” supplies, right equal protection lated Claimant’s Act, 77 P.S. Section under the Amend- the law Fourteenth 531(l)(ii), “In pertinent part, ment to the United States Constitution services, employ- addition to the above Pennsylvania and under the Constitution.3 for medicines and provide payment er shall treatment, hospital services Employer argues supplies, that Claimant waived appliances, supplies orthopedic alleged the issue of this violation because this sec- in accordance with prostheses the Board nor he neither raised before added). (Emphasis ...” tion. petition his review. pre- Assuming arguendo that Claimant to a determination of 3. Our review is limited Board, Claimant committed, issue before the served this an error of law was whether petition for to include it in his also failed necessary findings sup of fact are whether 1513(a), an is- to Pa.R.A.P. Pursuant review. evidence, ported by or whether substantial petition in a for review not raised sue Vinglin rights were violated. constitutional addressed and will not be waived considered Compensation Appeal Board sky Workmen’s TeledyneMcKay v. Workmen’s Court. Pa.Cmwlth. 15, (Penn Installation), 589 (Osmolinski), 688 Compensation Appeal Board (1991). A.2d 291 (Pa.Cmwlth.1997). A.2d 259 Compensation “orthopedic appli- that the van was not Rieger v. Workmen’s (Barnes Compa ance” under the Act: Appeal Board & Tucker (Pa. ),ny 104 Pa.Cmwlth. must, general The use of a vehicle Cmwlth.1987), this held that Barnes Court course, distinguished from the retro- be , Company, & Tucker vehicle, fitting of that without which the worker, injured (Rieger), Rieger Richard operated by vehicle could not be obligated for the re $433.02 claimant. It is the modifications and modeling Rieger’s for the installa home ‘appliances,’ not the vehicle additional ramps tion of bars and to make the home itself, necessary to accommo- which are wheelchair accessible and $359.34 injury. date the claimant’s work-related in Rieger’s installation of hand controls Thus, special retrofitting is an ‘or- determined that automobile. Court ..., while a van it- thopedic appliance,’ Rieger’s the alterations to home and auto self is not. “orthopedic appliances”
mobile constituted
Second, by analogy,
special
while the
306(f)(4)
injured
home
remodeling of
worker’s
§ 531.5
might
to make it wheelchair accessible
analogous
be
to the cost of
*5
Petrilla,
this Court addressed the
ac-
motor vehicle so that the vehicle is
question
specially equipped
of whether a
a
paraplegic,
cessible to
cost of
“orthopedic appliance”
van constituted an
analogized to the
might
van itself
also be
(Petrilla),
under the Act.
Petrilla
Robert J.
itself,
purchasing
cost of
the home
paraplegic as a result of a work-related
that
noncompensable;
argue
is
these
injury, petitioned
alleged
for review and
in
compensable
latter costs should be
is
part
People’s
(People’s),
Natural Gas
simply untenable.
had
a
employer,
provide
spe-
his
failed to
Petrilla,
firmed. argues Claimant also order People’s This Court determined that did Court should price light of the in of the duty purchase not have a under the Act to van, in nature and only of the the cost to retro- fact that the is remedial fit, to benefit the worker and must and affirmed. This Court reasoned is intended 306(f)(4) formerly 6. WCJs titled as referees. 5. Section of Act was renumbered were 306(f.l)(l)(ii) by Act 44 of on Section 1993 essentially July This remains the same.
429 Act, ance,” 77 humani liberally construed to meet its be 531(3)(i), part: pertinent P.S. Hannaberry goals. tarian HV AC Work determines that If the commissioner (Snyder, Board Compensation Appeal ers’ particular a allowance for (2008). Jr.), Pa. 834 A.2d the Medicare or under group service hu cognizant While this Court reasonable, may adopt is not program of the Act and is sensi purpose manitarian If the a allowance. by regulation new faces, this tive to the difficulties Claimant schedule, recom- charge, fee prevailing receives agree. Court does not fee, charge, DRG inflation index mended compen compensation workers’ benefits or group] payment [diagnostic-related and, wage sate him for his loss not been reimbursement has other expenses paid. his medical are His program calculated under the Medicare product inability the Van is treatment, accommoda- particular for a circumstances, financial not his of his own service, amount of tion, or product the hu injury. given work-related Even may eighty per not exceed payment purposes manitarian this Court charge most often made centum of the duty Employer by placed upon can find no training, experi- by providers similar Assembly the General specific treat- ence and licensure for Van.7 ment, accommodation, product or ser- geographic area where vice Employer’s Review. accommodation, II. Petition for treatment, product provided. service is Employer contends that the Board Here, Em- Board determined that erred when it affirmed the WCJ’s decision limit- obligation was not ployer’s payment *6 required Employer to reimburse because eighty percent of the cost ed Claimant for the total cost of 306(f.l)(3)(i) pro- Act limits of the Section the Van and for the total cost of two than the fee receiving from more viders months van rental. provid- that a Board reasoned cap and the provid- care under the Act was a health er In that this Court determined Here, that no health care it is clear er. is an special retrofitting vehicle indirectly advised or even provider was “orthopedic appliance” under the Act. Sec- in the retrofit- or involved either consulted Act, tion of the 77 P.S. of the or in the rental ting of the Van 531(l)(ii), provides § that an prior to the accessible vans wheelchair provide payment “orthopedic ap- shall agreed The Board of the Van. pliances.” apply that the limits did with the WCJ In the amount of full order determine was liable for the and that “orthopedic appli- for an cost.8 payment required li), sought petition and also Rieger a fatal claim supports his filed
7. Claimant asserts that
(Villanova)
University
reim-
to have Villanova
position.
Rieger
inapposite.
The
Independence Blue Cross
burse
orthopedic appliance
under Pe-
van is not
$10,765.00,
Indepen-
amount
the full
trilla.
paid to Cardelli’s health
dence Blue Cross
WCJ ordered Villanova
University
providers.
care
8. The Board relied on Villanova
(Man-
pay,
Board affirmed. Villanova
and the
Compensation Appeal Board
Workers'
capped
(Pa.Cmwlth.2001),
liability
in accord
tle),
petition
argued that
was
its
to the cost provisions containment of Sec- pensation Appeal Board’s order which af- tion then there is firmed the WCJ’s decision which ordered no basis for reimbursement whatsoev- Farm, Seven Stars Inc. the total er under the Act because there was no cost to retrofit the van and the van rental medical involved. This Court is for two months. agree
constrained to that under the Act BY Judge DISSENTING OPINION Employer’s obligation capped eighty at FRIEDMAN. percent of the cost to retrofit the Van I respectfully dissent. Unlike the ma- for the van rental. (Claim- jority, agree I with David Griffiths Accordingly, por- this Court affirms that ant) Farm, (Employ- Seven Stars Inc. tion of the Board’s order which reversed er) $18,000 responsible WCJ’s determination that price of Claimant’s 2000 Ford Windstar required for the Van. This (Van) $10,000 as well as 100% of the Court portion reverses that of the Board’s cost to retrofit the toVan make it wheel- *7 order which affirmed the WCJ’s decision chair-accessible and the full for cost two Employer which ordered to pay the total months of van rental.1 only because it provider limits what a medical distinguishable pres- Villanova is from the may charge compensated by when it is subroga- an ent case in that Villanova dealt with employer and that payments Section 319 of the tion and did not address for ortho- 671, applied P.S. pedic appliances. because it addressed the The Board’s reliance was “[wjhere employee misplaced. situation has received payments disability for the or medical ex- parties stipulated pur- 1. The that Claimant pense resulting injury from the in the course $18,000 chased the Van for that the employment and Van paid by employer of his the or was retrofitted to make it wheelchair-accessi- company inju- insurance on the basis that the $10,000. addition, ble for another In ry disability compensable Claim- and were not under $2,085.09 paid ant agreement act in for wheelchair-accessible this the event of an or award 22, 2000, injury employer van rental from December to Janu- for that the or insurance 20, 2001, $1,968 ary company paid and payments who made the for wheelchair- shall be 21, 2001, subrogated agreement January out of the accessible van rental from or award to paid, right February Employer subrogation the amount so if the to to 2001. reimbursed agreed by parties is to the or is established at Claimant for of the cost to retrofit the 80% hearing the time of before the referee or the Van and the of van rental cost. In this 80% Villanova, regard, clearly board.” at Employer 783 A.2d I would note that is provid- of a health care disability charges limits the Claimant received benefits and, er, no health care by a because Employer being from after struck involved, to limited not injuries ren- was hay, sustaining bale of that reimbursement; rather, could re- he 80% quadriplegic. dered Claimant a Subse- con- actual cost of the reasonable cover quently, penalty petition Claimant filed a accessibility verting the Van for wheelchair violated the Work- alleging Employer (WCJ’s all rental (Act) and could recover fees. to Compensation by failing Act2 ers’ 2). Law, Accordingly, No. Conclusion necessary quadri- pay for reasonable granted penalty peti- the WCJ Claimant’s transportation. Fortu- plegic accessible full the Employer tion and ordered nately, litigated, while case was being this Van, and the of the the from a money Claimant was able to borrow charges. rental him family purchase friend that allowed Van, which then retrofit- the had to the appealed Workers’ to make it ted wheelchair-accessible. (Board), Appeal Compensation Board part which affirmed reversed compensation judge Before the workers’ Relying part. on Petrilla Workmen’s (WCJ), parties stipulated the there (People’s Compensation Appeal Board (1) were three for issues resolution: Gas), (Pa.Cmwlth. Natural whether Claimant is entitled reimburse- 1997), the held that Board Van; purchase price ment of the hable for of the price (2) whether Claimant is to reim- entitled Board Van. affirmed 100%, 80%, only for or bursement to retrofit WCJ’s decision that costs (3) Van; cost to retrofit the whether limit and the van rental were not 100%, only Claimant was entitled to by provision the cost containment ed 80%, By the van cost of rental. parties petitioned Act. Both court for this April 30, decision order dated review. that the WCJ concluded modifications make the Van wheelchair-accessible re- ruling petition In on Claimant’s constituted an expense “orthopedic ap- view, majority affirms Board. pliances” under majority result reasons 1.) (WCJ’s Law, Act.3 Conclusions No. by that the dictated which holds addition, that a WCJ concluded “orthopedic appliance,” term reasonable cost to itself the Van responsible (WCJ’s 306(f.l)(l)(ii) was also recoverable Claimant. to the refers 3.) Law, regard Conclusions No. With equipment needed to retrofit a van issue, the cost containment con- make it wheelchair-accessible but does WCJ *8 itself. cluded that section of the Act not include the cost of the van 1915, amended, 736, prejudiced by I the result would reach 2. Act of June P.L. 1-1041.4, agreed §§ Employer 2501-2626. here. Consider that has responsible that is for Claimant's 80% 531(l)(ii). § to rent a van and that Claimant’s van rental That 3. 77 P.S. section $2,000 appear average monthly. part, costs pertinent "In addition to the above in Therefore, service, provide employer payment would have to reimburse shall $1,600 month, approximately supplies, hospital treat- a medicines and for $19,200 Thus, $18,000 ment, year. spending orthopedic a supplies a on services and many years with appliances, prostheses would in Van that last Claimant for accordance 531(l)(ii) appear prudent (emphasis would to be a course for this section.” 77 P.S. added). Employer to take. 432
However, majority a concluding reverses that wheelchair was an ortho- Board’s determination pedic appliance paraplegic for the claim- must for ant, reimburse Claimant the total Judge Rieger stated in that: Colins retrofitting cost of the Van and two necessary, a it wheelchair is then “[I]f following months of van rental. For the logically follows that minor modifications reasons, I that Employer believe is re- needed to facilitate the appli- use sponsible original purchase price for the necessity.” ance must also be considered a pursuant the Van section Petrilla, In in Judge Id. at 87. his dissent requires stated, Mirachi employer “orthopedic appli- [cjlaimant’s Rieger, injuries in if the [a]s ances,” and that Petrilla should be over- home, impossible make it to leave his Further, ruled. I believe the remedial nature of the Act would be 306(f.l)(l)(i) apply of the Act does not provide frustrated a failure to a one- limit Employer’s payment obligation for therefore, I, expenditure. time conclude retrofitting and rental costs. [cjlaimant requested by that the van in
I. Petrilla should be overruled
this matter
orthopedic appli-
falls within
306(f).
ances under Section
Petrilla,
In
this court held as a matter
impression
of first
that an
is not Petrilla,
(Mirarchi, S.J.,
tinguish by treating quadri- Petrilla bile due to a work-related accident but plegic differently here paraplegic from the money buy who does not have the a van Petrilla, in such a distinction is not tena- that can accommodate a wheelchair and ble; neither the claimant in Petrilla nor equipment necessary to lift that wheel- Claimant here could obtain medical treat- chair into the van is left immobile and medically prescribed ment without the van home, trapped inside his to even unable thus, mobility standpoint, from a these care, in participate obtain medical let alone indistinguishable. situations are in participated the activities he once before agree Judge I with Mirarchi’s Senior injury. his Petrilla, dissent wherein he relied on disparity This the claimant in between Rieger Compen- the case of v. Workmen’s Rieger, who could receive benefits to allow Board, Appeal sation Pa.Cmwlth. feet, beyond him to become mobile (1987). Rieger, para- the claimant who was refused for a plegic claimant was awarded benefits benefits for a retrofitted van that would him spinal injury cord that cost the use of mobile, have allowed him to become legs. employ- his This court held that the humanitari- *9 contrary and to the untenable to for modifications to the pay er had Act; thus, not purposes it should claimant’s home and for hand-control mod- cata- be followed here where the more him to ifications to his vehicle to enable because, strophic quadriplegic situation of this employer if to drive were allowed Further, bills, must be considered. refuse to these the na- Claimant remedial similarity Rieger and ture of the Act would be frustrated. After the between Claim- the price of of to borrow the readily recognizable in view able ant here that, distinguish not a should quadriplegic a claimant from friend the fact for Van claimant totally similarly as a result of a work- a situated immobilized him from injury, related a retrofitted wheelchair-ac- a such friend. without big a equivalent van the of cessible Furthermore, majority in Petrilla the steering motorized wheelchair with a requiring employer concerned that was This motorized wheelchair Van is wheel. a a could be burdensome provide to vehicle necessary equipment to allow orthopedic however, sup- not History, does expense. to public to roads Claimant traverse first a Petrilla was the such concern. port as he enjoy quality a minimum life depen- in this of a appeal Commonwealth struggles to the medical treatment obtain the use of a retro- paraplegic seeking dent necessary to him alive. It enables keep van, and, year period in the seven fitted “mobile,” although to to Claimant become case present apparently since ridiculously comparison a limited extent in Fortunately, only other such case. is the mobility being injured while to his before isolated, injuries are extreme- catastrophic serving por- In the Employer. discussion hardly and the normal risk to be ly rare decision, tion of his concluded WCJ expense. as a burdensome calculated that, Moreover, to section pursuant [wjithout van, retrofitting a with 306(f.l)(l)(i), re- all services are medical accessibility, paraplegic wheelchair this I this be believe quired to reasonable. Claimant is confined his home [sic] to employ- protection sufficient limited, if injury; due to work ers.4 totally precluded, obtaining even hold Accordingly, I that wheel- would attention, family medical since had this ap- “orthopedic is an chair-accessible van no other to enable vehicles Claimant Section pliance” get to trans- appointments, medical I require and would portation provided by was not the Carri- in itself addition er. the costs retrofit Van. (WCJ’s 4.) van, Thus, decision at without have been trav- Claimant would not able to provisions II. The cost containment necessary to his medi- el doctor’s office inapplicable are Act cal treatment or to the store to 306(f.l)(l)(i) provides, Section Moreover, necessities of life. he would part, in relevant that: little quality lose the bit that is left of his (l)(i) provide pay- The shall in by being participate of life unable to this with ment accordance many other activities the home outside ser- surgical medical reasonable enjoyed that he before work-related vices, by physicians rendered services certainly The intend- legislature accident. .... providers health care or other who, ed that claimant like Claimant added). 531(l)(i) here, (emphasis his proves that such restrictions on are found provisions to his containment life were caused his services pro- to the employer is entitled full benefits was that: Act. The mere fact that vides Therefore, we case, lenge determination. already In this the WCJ determined to the to remand this case would not need the cost the Van reasonable, findings this issue. WCJ for on does not chal- *10 (3)(i) clause, pro- such, purposes For of a providers. this health care As the intent require, request vider shall not or ac- charges of this section is to limit the of treatment, cept payment for the ac- provided by medical services health care commodations, products or services in A providers. wheelchair-accessible van is per excess of one hundred thirteen cen- a “medical service” because it allows the tum of the prevailing charge at the sev- injured claimant to and immobile become enty-fifth percentile; one hundred thir- mobile. it is not a medical ser- per teen centum of applicable fee provided by provider. vice a health care schedule, the fee or recommended such, pro- As the medical cost containment inflation charge; index one hundred 306(f.l)(3)(i) visions of section would not per thirteen centum pay- of the DRG apply expense “orthopedic to the for this plus pass-through appli- ment costs and appliance,” provided the cost of which is outliers; day cable or or one hun- 306(f.l)(l)(ii). per any dred thirteen centum of other Therefore, portion I would affirm that mechanism, Medicare reimbursement the Board’s order which affirmed the by determined the Medicare carrier or ordering Employer pay WCJ’s decision
intermediary, pertains whichever to the the total cost to retrofit the Van and the involved, specialty service determined to addition, van rental for two months. I applicable be in this Commonwealth un- portion would reverse that of the Board’s program der the Medicare for compara- order which reversed the decision WCJ’s ble services rendered. If the commis- requiring Employer for the cost sioner determines that an allowance for WCJ, Like I the Van itself. would a particular provider group or service hold that must the entire program the Medicare is not rea- retrofitted, cost of the wheelchair-accessi- sonable, may adopt, by regulation, it ble Van and the van rental charges without new allowance. the prevailing If any reduction under the cost containment schedule, charge, fee, recommended fee provisions of Act. charge, payment index DRG inflation or other reimbursement has not Judge joins in PELLEGRINI pro- been calculated under the Medicare dissent. treatment, gram particular accom- modation, service, product or amount the payment may not exceed
eighty per charge centum most made providers similar train- often COLA, Dante J. Petitioner ing, experience spe- and licensure for a treatment, accommodation, cific product geographic service area where STATE CIVIL SERVICE COMMIS- treatment, accommodation, product (DEPARTMENT SION OF CON- provided. or service is AND RE- SERVATION NATURAL 531(3)(i) added). (emphases Reilly), Spring E. SOURCES Respondents.
The Board that the cost con- reasoned provisions apply tainment do not Pennsylvania. Court of Commonwealth in this case because the services of retro- Argued Sept. 2004. fitting renting the Van and a van were not Decided Nov. provided by provider. a health care I agree. would When section providers, referencing
references