Hospital and EMS liens

When a hospital lien attaches

Section 55.002 says a hospital has a lien on a cause of action or claim of a person who receives hospital services for injuries caused by an accident attributed to the negligence of another person. For the lien to attach, the person must be admitted to a hospital not later than 72 hours after the accident. The lien extends to the admitting hospital and to a hospital the person is transferred to for treatment of the same injury.

“Admitted” is broader than an overnight stay. Section 55.0015 says a person is considered admitted if allowed access to any department of the hospital for any treatment, care, or service. An emergency department visit can count.

EMS liens are different, and county size matters

Section 55.002(c) gives an emergency medical services provider a lien on the claim of a person who receives emergency medical services in a county with a population of 800,000 or less, within 72 hours after the accident. Harris County is far larger than that, so this EMS lien provision may not apply to EMS services provided in Harris County; it may apply in smaller surrounding counties. Check where the services were provided. Section 55.004(f) limits an EMS lien to the amount charged, not to exceed $1,000, for services in the 72 hours after the accident.

What the lien attaches to, and what it does not

Section 55.003 says the lien attaches to the cause of action for damages, to a judgment, and to the proceeds of a settlement of the claim. It does not attach to a workers’ compensation claim and certain federal compensation claims, and it does not attach to the proceeds of an insurance policy in favor of the injured person, except public liability insurance carried by the insured that protects against loss caused by an accident or collision. The notice the hospital sends must tell the patient that the lien does not attach to real property owned by the patient.

How much a hospital lien can be

Section 55.004(b) says a hospital lien is for the lesser of three amounts:

1. the hospital’s charges for services during the first 100 days of hospitalization;
2. 50 percent of all amounts the injured person recovers through the cause of action, judgment, or settlement; or
3. if a trier of fact specifies an amount awarded for hospital charges, that amount less a pro rata share of reasonable attorney’s fees and expenses.

The section also says a lien does not cover charges that exceed a reasonable and regular rate for the services, and it addresses when certain emergency physician charges in the first seven days may be included or excluded, including where insurance benefits were accepted.

How a lien is secured

Under Section 55.005, to secure the lien the hospital or EMS provider must file written notice with the county clerk of the county where services were provided, before money is paid to the person entitled to it because of the injury. The notice must include the injured person’s name and address, the date of the accident, the provider’s name and location, and the name of the person alleged to be liable, if known. The provider must also mail the injured person a notice, generally within five business days after learning the lien was recorded, saying the lien will attach to any claim and does not attach to real property. The statute says failing to receive that mailed notice does not make the lien invalid.

County clerk records are public. If you are unsure whether a lien was filed, the county clerk of the county where you were treated is the office that records it.

Why it matters before a release

Section 55.007 says a release of a cause of action or judgment to which a lien may attach is not valid unless the provider’s charges were paid in full before the release, or were paid to the extent of the consideration paid to the injured person, or the provider is a party to the release. In practice, insurers paying an injury settlement usually want liens resolved first. The injury claims and releases page covers other questions to answer before signing.

Discharge

Section 55.006 says a lien is discharged when the provider files a certificate with the county clerk stating that the debt has been paid or released. If a lien was paid, ask the provider for confirmation that the certificate was filed.

This page is not legal advice, and Crash Steps is not a law firm. For insurance questions, TDI’s Consumer Help Line is 800-252-3439.