Court of Appeals: Pharmacies are Health Care Providers Subject to One Year Statute of Limitations

LI  - WCCW_Summit_042021


In Summit Pharmacy, Inc. v. Costco Wholesale, Record No. 0970-20-1 (Mar. 30, 2021), the claimant was under a medical award. Summit Pharmacy (“Summit”) provided prescriptions to the claimant for her injury and the employer made partial payments to Summit for those prescriptions. Four years after Summit received its last partial payment from the employer, Summit filed a claim seeking full repayment.

Va. Code § 65.2-605.1 allows health care providers to file claims contesting the sufficiency of payment up to one year after the last payment received.  Summit alleged that the statute of limitations did not apply because as a pharmacy they were not a “health care provider.”  

The Court of Appeals disagreed. The Court analyzed several other provisions of the Code of Virginia, ultimately finding that a pharmacy is a health care provider in the context of Va. Code § 65.2-605.1. The Court found that Summit’s claims were barred by the statute of limitations in § 65.2-605.1 because they were not filed within one year of receipt of the last partial payment. This Opinion is not yet final and may still be appealed.

Read the opinion.

Read the previous edition of Workers' Compensation Case Watch:

Supreme Court of Virginia Rules on Obvious Sudden Mechanical or Structural Change in Workers’ Compensation Case

Thumbnail_300x300_Jessica Trivizas

Jessica Hacker Trivizas is a litigator who focuses her practice on workers’ compensation, defending employers and carriers at the trial and appellate levels. She works with insurance carriers, third-party administrators, and self-insureds. Jessica worked on some of the largest settlements in the country, including the historic NFL Concussion Settlement Program, the BP Oil Spill settlement, and the Reglan/MCP Settlement Program. Her background on these mass claims resolution programs gives her unique insight into the work of claims adjusters.