In Farmer-Cummings v Personnel Pool of Platte County, 110 S.W.3d 818 (Mo. Banc 2003), claimant appealed from Commission decision which awarded claimant compensation for past medical expenses but refused to award her compensation for amounts written-off or adjusted from the original medical bills by healthcare providers. Court of Appeals held that if claimant remains personally liable for any of the reductions, she is entitled to recover them as “fees and charges” under §287.140. If the reductions resulted from sources independent of employer, they are not to be considered under §287.140 and claimant can recover. However, if the respondent establishes by a preponderance of the evidence that the healthcare providers allowed reductions for their own purposes, claimant is not entitled to any windfall recovery. Reversed and remanded to determine claimant’s liability for past medical expenses.
In Curry v Ozarks Electric Corp., 39 S.W.3d 494 (Mo. Sup. banc, 2001), if a health care provider, under Section 287.139(6) files a claim for direct payment where services had been authorized in advance by the employer/insurer, but are unpaid, and the proper notice has been filed with Division or ALJ, it may order direct payment from the proceeds of any settlement or award. Here the medical providers claim for $105,000 in medical bills was an issue that was “left open” in the compromise settlement. The Court, upon determining the reasonableness of the bill, allowed full payment directly to the provider.