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Hospital Liens: I Received a Hospital Lien in the Mail After My Accident. What Do I Do Next?

You just were injured by another person in a car accident and were transported by the EMS to a local hospital like UMC, Sierra Providence, Las Palmas or Del Sol. Several weeks later, you receive a letter from the hospital entitled “Notice of Hospital Lien”. What are you to do? Does it mean that the hospital is going to file a lien on your property or house? Should you respond immediately to the hospital to pay the hospital bill? What are my options? These are common questions that we receive from our car accident clients when they receive notice of a hospital lien in the mail. We have all the answers to hospital lien questions that you may have in this article.

Is the hospital filing a lien on my house or other property?

The answer is fortunately no. The hospital is not attempting to file a lien on your house or other property. Texas Property Code Chapter 55 is the statute that governs hospital liens. The hospital lien statute only gives a hospital certain rights to the proceeds of a settlement against the other person that caused the accident. The hospital is allowed by law to file a notice of lien before money is paid to you by the other person’s insurance in order to be paid out of any settlement or judgment. By filing a hospital lien, the hospital is attempting to take all or a portion of your personal injury settlement. Knowing the law is the first step in either negotiating the hospital lien or having it declared invalid.

How does the hospital lien work, I’m confused?

Texas Property Code Chapter 55 states that a hospital has a lien on a cause of action or a claim of a person who receives medical treatment at a hospital caused by an accident that is someone else’s fault or negligence. For the lien to attach (or be applicable), the person must be admitted to a hospital not later than 72 hours after the accident. The lien applies to a cause of action against the at-fault driver, any judgment you receive from the at-fault driver, and the proceeds of any settlement you receive from the at-fault driver provided that the lien is valid and secured. The lien applies to the admitting hospital and any hospital where the patient is transferred for treatment of the same injury. The hospital lien may also apply to an EMS provider (up to $1000 in counties of 800,000 people or less).

A hospital lien may also include the amount of a physician's reasonable and necessary charges provided to the injured person during the first seven days of the hospitalization. The hospital may act for the physician as its agent in securing the lien.

Typically, our clients go to the hospital immediately after the accident. However, if you go to the hospital 4 days or more after the accident, then the lien would not be valid. Further, the hospital lien statute states that the person must be “admitted” to the hospital. One question that has not been fully answered by Texas courts is whether a person who only goes to the emergency department of a hospital and is not admitted to a floor for further testing, treatment, or observation is actually “admitted” to the hospital for the lien to attach.

These are questions that a good car accident attorney will answer in order to help you negotiate with the hospital. It is important for you to know that the hospital, by filing a hospital lien, is attempting to compete with you for your settlement proceeds. Knowing every aspect of the hospital lien statute helps us either eliminate the lien altogether or to negotiate the best possible amount with the hospital.

Does the hospital lien apply to all benefits that I receive in an automobile accident?

No, the hospital lien only applies to money that you receive from the at-fault driver and his or her insurance. Texas Property Code 55.003(b) states that the lien does not apply to many situations in which you might receive compensation after an auto accident. A hospital lien does not apply and attach to money you receive from a worker’s compensation claim if you were injured on the job and received worker’s compensation money from the car accident. The hospital lien statute also does not apply to money you receive from your own automobile insurance. For example, if you receive uninsured and underinsured motorist protection (UM/UIM) money out of a car accident, the hospital does not have any rights to those proceeds. The same is true if you receive personal injury protection (PIP) or medical payments coverage (Med Pay) from your own insurance.

The hospital is trying to charge me an insane amount of money for a visit to the emergency room. Is there any way to fight the hospital’s charges?

This is the most frequent question that we receive. Most frequently, a patient goes to the ER after an accident for a few hours and is discharged. Several weeks later, the client receives a very expensive bill from the hospital along with a notice of a hospital lien. We have seen a few hours visit to the emergency room exceed $50,000. More commonly we see hospital bills range from $10,000 to $20,000. The typical automobile insurance policy only covers per person losses up to $30,000 so a large hospital bill can eat up all or nearly all of a personal injury settlement. Is there anything that can be done?

There are some protections to fight the hospital bill set forth in Texas Property Code Chapter 55. First, the hospital can only charge for the patient’s first 100 days of treatment. We rarely see this situation, but it could help in a catastrophic injury case with lots of money at stake.

More importantly, the hospital lien statute provides that a hospital lien does not cover “charges for services that exceed a reasonable and regular rate for the services.” If you receive a hospital lien notice, we promise you that the hospital will not send a bill with any sort of discount. You will receive the hospital’s chargemaster rate a/k/a the “whole enchilada”. The chargemaster or CDM rates will contain highly inflated prices at several times the cost of actual charges that the hospital could normally collect. If private insurance or Medicaid or Medicare were to pay for your hospital bill, the hospital would only be able to collect “pennies on the dollar” of the chargemaster rate. Why then should the hospital be able to collect such an exorbitant fee from you from personal injury case?

This is where a good personal injury lawyer can help negotiate the hospital lien and charges in order to put the most amount of money in your pocket from a settlement. Your car accident attorney should be able to negotiate a deep discount of the hospital lien. If the hospital still will not lower or significantly reduce its lien, your lawyer should file a lawsuit for you. There are several types of claims that can be made against the hospital, including a claim that the hospital has filed a fraudulent lien or a declaratory judgment action asking the court to reduce the lien because the hospital’s bill exceeds the reasonable and regular rate. Our firm has successfully sued for or negotiated thousands of hospital liens on behalf of our injured clients.

Are there any other ways to fight a hospital lien?

Yes. There are certain procedural hurdles that the hospital must undertake to secure its lien. Texas Property Code 55 provides that the hospital must provide written notice by mail to the injured individual informing the individual that the lien will attach to any cause of action or claim the individual may have against another person for the individual's injuries; and that the lien does not attach to the individual’s real property. The lien notice must be sent not later than the fifth business day after the date a hospital receives notice from the county clerk that a notice of lien filed has been recorded in the county records. So, once the hospital receives notice that the lien has been filed by the county clerk, the hospital must provide written notice of the lien within five business days to the individual. Otherwise, the lien is invalid. These “technicalities” must be complied with, otherwise, the lien is invalid. A good injury lawyer can assist in invalidating a lien if the hospital is sloppy and does not comply with the letter of the law.

If you have received a notice of hospital lien and would like assistance or have questions, please call one of our personal injury attorneys at Harmonson Law Firm at (915) 584-8777 or contact us online here. We have extensive experience fighting and negotiating hospital liens and can help you with your specific situation. Harmonson Law Firm’s primary office is located in El Paso, Texas. We represent injured clients throughout Texas, New Mexico, Arizona and California.

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