Georgia’s Personal Injury Medical Lien Law: A Review of Recent Changes
By: Ken Sisco
In July 2023, amendments to Georgia’s personal injury medical lien statute went into effect. O.C.G.A. §§ 44-14-470 through 44-14-477 provide certain medical providers with a lien against the proceeds of a personal injury case for medical services provided to a personal injury claimant.
Who Can Claim a Lien?
The statute provides lien rights to physician practices, hospitals, nursing homes and traumatic burn care practices. This latest amendment added chiropractic practices to the list of qualified medical providers. The statute appears to be directed at providing lien protections mainly to medical providers in Georgia. For example, for chiropractic practices and physician practices to qualify they must have one or more Georgia licensed chiropractors or physicians in the practice. Similarly, for hospitals to qualify, they must be subject to the regulation and licensure of the Georgia Department of Community Health.
Notwithstanding the same, there are no specific requirements that nursing homes or traumatic burn care practices have ties to Georgia. A nursing home simply needs to be an intermediate care home, skilled nursing home or an intermingled home to qualify; while for a traumatic burn care medical practice to qualify, it only has to provide more than $50,000 in services arising out of a single accident.
Scope of the Lien
The statute provides a qualified medical provider “shall have a lien for the reasonable charges” for the treatment of an injured person. The treatment must be necessary and for injuries which give rise to the injured person’s cause of action. The lien is only against the cause of action and is not a lien against the injured person.
All liens under this statute are secondary to any attorney lien on the cause of action. A lien of a chiropractic practice is not only secondary to an attorney lien but is also secondary to a hospital lien.
Who is Subject to the Lien?
Not only is the person receiving medical treatment subject to the lien, but the alleged tortfeasor and the tortfeasor’s insurance carrier are also bound by a properly perfected lien. The statute specifically provides the qualified medical provider can bring an action against the tortfeasor and/or the tortfeasor’s insurance carrier to enforce the lien.
Another Recent Change
Properly perfected statutory liens of qualified medical providers are extremely powerful and have limited defenses. Given the strength of the lien claim, it is not uncommon for medical providers to not submit their bills to an injured person’s health insurance provider, rather those medical providers seek to enforce their lien. The logic being that many health insurance providers have negotiated discounted rates with medical providers, and submitting the bills to the health insurance providers would result in the medical providers receiving less money. However, effective July 1, 2023, to assert a valid lien, a qualified medical provider must first submit a claim for payment of the medical bills to an injured person’s private health insurer provider.
At first blush, this would seem to suggest that for every injured claimant with private health insurance, there would not be a statutory lien from qualified medical providers. However, pre-existing caselaw shows the medical provider would still have a lien for the reasonable cost of its medical services that were not paid by the health insurance provider. Specifically, in MCG Health, Inc. v. Kight, 325 Ga. App. 349, 354 (2013), aff'd, 296 Ga. 687 (2015), the Georgia Supreme Court concluded, despite the absence of debt owed to a hospital under its contract with an injured claimant’s private healthcare provider, a qualified medical provider still has a lien claim pursuant to O.C.G.A. § 44-14-470 for any unpaid medical bills, i.e. write-offs, deductibles and co-payments.
Practical Considerations
The recent changes to O.C.G.A. §§ 44-14-470 through 44-14-477 may not be as dramatic as they initially appeared, nonetheless they still benefit insurers and their insureds.
The requirement that medical bills must be presented to an injured person’s private health insurance carrier still makes a significant impact on personal injury cases. Though there will be many cases where the claimant does not have private health insurance, therefore making this change irrelevant, there will still be many more claims where private health insurance exists. In those cases, if the medical provider does not submit its bills to the claimant’s private health insurance provider, it will not have a valid lien claim.
By the same token, if the qualified medical provider does submit the medical bills to the claimant’s private health insurance provider, there are several benefits for the tortfeasor and insurer. First, the amount of the lien claim should be reduced and likely reduced by a good amount. Second, at some point the medical provider will need to disclose the amount that it accepted as full and final payment for the medical bills if the treatment was not related to a personal injury claim. This should provide the tortfeasor and insurer with a very strong argument that the reasonable value of the qualified medical provider’s services was what it has already received.
In light of the foregoing, the analysis and information required to best assess the validity of a statutory lien to recover bills for medical treatment of an injured person has changed. The existence of private health insurance is now much more relevant since a claimant’s access to health insurance will significantly impact his medical provider’s rights to a statutory lien for payment of their medical service related to claimant’s cause of action.
Attorney Contact Info
Ken Sisco
ken.sisco@swiftcurrie.com
404.888.6238