Resolving Medical Provider Liens in Virginia Personal Injury Cases
The state and federal government, health insurance companies, medical providers, the military, and workers’ compensation insurance companies can assert a claim against your personal injury settlement for benefits paid or services rendered. These claims are known as personal injury liens. If you’ve been hurt in a car accident, damaged by medical malpractice, or injured by someone else’s negligence, it’s important that your personal injury lawyer identify and negotiate all liens against your personal injury settlement or verdict.
This article takes a look at a common lien asserted in Virginia personal injury cases: the medical and health care provider lien. We’ll explain the applicable statutes, how they may apply to your case, and what you can do to reduce the amount of the health care provider lien so that you recover more damages for your personal injuries. If you have any questions or concerns, or if you’re looking for high-quality legal representation, contact Corey Pollard for a free consultation.
What is a Lien?
A lien is an interest that one party asserts against another person’s property.
Your mortgage, for example, is a lien. The mortgage company has an interest in your house until you have made all the payments owed under the mortgage. If you fail to make a payment on time, then the lender can use its lien to force a sale of your house or to take over possession over the property. A car loan is another example of a lien.
Liens are also common in Virginia personal injury cases. In this context a lien is a claim against the injured person’s financial recovery – either through settlement or verdict. The lien must be paid or negotiated before any money can be distributed to the injured person.
Health Care Provider Lien in Virginia Code Section 8.01-66.2
Virginia Code Section 8.01-66.2 provides health care providers with a lien against the person, firm, or corporation whose negligence caused your person injuries. Health care providers covered under this section include: public hospitals; private hospitals; nursing homes; physicians; nurses; physical therapists; pharmacists; chiropractors; and, emergency medical services and transportation.
There are, however, caps on the lien amounts for each health care provider. The caps are as follows:
- $2,500.00 to hospitals and nursing homes
- $750.00 to each physical, nurse, physical therapist, or pharmacy;
- $200.00 for each emergency medical services agency (ambulance service).
The law is unclear as to whether a hospital or nursing home can claim that each physician, nurse, or physical therapist involved in treatment related to the personal injuries is entitled to a separate lien in addition to the hospital’s lien amount of $2,500. This is an area of dispute, which means it is an area ripe for negotiation. The law does not prohibit a hospital that employees physicians or nurses, a practice that is becoming more common, from claiming both a hospital lien and a doctor lien.
The statutory health care provider lien in Section 8.01-66.2 is not perfected unless written notice of the lien is given to the injured person’s attorney or to the person, firm, or corporation whose negligence caused the person’s injuries. Virginia Code Section 8.01-66.5. If the medical provider fails to give written notice then it does not have a valid lien.
If an attorney receives notice of the health care provider’s lien and does not satisfy the lien out of the personal injury settlement or proceeds, then the lien holder may pursue a claim against the attorney. The attorney’s liability is limited to the amounts provided in Virginia Code Section 8.01-66.2, unless a state run medical facility is the lien holder. Because of the liability and ethical responsibilities imposed on your attorney, he or she will not release funds to you until all lien issues are resolved.
Health care costs are out of control. And if you’ve ever reviewed an explanation of benefits or hospital bill, you know that it’s difficult to tell what you were billed for and why you were billed each amount. So it’s possible that the health care provider charges that make up the personal injury lien are unreasonable. Or that the bill is inaccurate or includes medical treatment that you did not receive.
You can question the reasonableness of the charges made by your health care providers claiming a lien pursuant to Section 8.01-66.2 by filing a petition in the court that would have jurisdiction over the claim if the health care provider were to assert a claim for medical expenses against you. The court will hear the matter and issue a decision five days after notice is given to the other party in interest (the health care provider). This procedural mechanism is provided by Virginia Code Section 8.01-66.7.
Another thing to remember when deciding whether to settle your personal injury claim: the lien provided in Section 8.01-66.2 for health care providers is inferior to the attorney’s lien for professional services rendered to the injured person.
Health Care Provider Lien Based on Written Agreement
Virginia Code Section 8.01-66.2 is not the only way that a health care provider can assert a lien against your personal injury claim. Some medical providers may agree to treat you after your initial accident or injury if you don’t have insurance, but only if you sign a written agreement stating that you will pay the provider in full after your personal injury claim is resolved. This is known as treating on a “lien basis,” and it is a common practice. Your attorney may know qualified orthopedic doctors or neurologists who will treat you on a lien basis and provide evidence if necessary in your personal injury case.
Negotiating a Lower Medical Provider Lien Amount in Virginia Personal Injury Cases
It’s possible to get the health care provider to accept less than the amount of money they billed you. Why would your hospital or doctor accept less money? Two reasons:
- Medical providers are used to accepting less than the full amount they bill from insurance companies, Medicare, and Medicaid. Because of this, the medical provider may be worried that if you challenge the reasonableness of the fees charged for medical treatment you will win. The medical provider will have wasted time and money in attorney fees only to be told by the court that their charges are unreasonable. By negotiating with your attorney directly the medical provider can cut any losses and recover funds.
- If the insurance company offers a settlement amount that would almost entirely go to your medical providers’ liens, then you have no reason to accept the settlement offer. Instead you’ll go to trial, where you may lose. If you go to trial and lose, or receive a verdict that is lower than the settlement amount, then the health care provider may receive nothing or much less than you’re willing to give in lien negotiations. The health care provider can reduce its risk by negotiating the lien to a lower amount.
Have a question about negotiating the medical provider lien in your Virginia personal injury case? Contact Corey Pollard today. We help injured workers and accident victims negotiate health care provider liens in personal injury, medical malpractice, workers compensation, and long term disability claims.