1.
Lien attachment
2. Usual and customary charges
3.
Miscellaneous
1. Lien attachment
The
lien of a service provider under this section attaches at the time the services
are performed for purposes of the application of this section. In re Conservatorship
of Holle, 254 Neb. 380, 576 N.W.2d 473 (1998).
A hospital lien
under this section attaches on a patient's admission to the hospital for treatment.
Ehlers v. Perry, 242 Neb. 208, 494 N.W.2d 325 (1993).
2.
Usual and customary charges
In
this section, the phrase "usual and customary charges" acts as a cap; it prevents
the lien from being an amount greater than what the health care provider typically
charges other patients for the services that it provided to the injured party.
Midwest Neurosurgery v. State Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572
(2004).
Under this section, the lien is equal to the debt still
owed to the health care provider for its usual and customary charges. Midwest
Neurosurgery v. State Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572 (2004).
Usual and customary charges
are the charges of the service provider instead of the amount actually collected.
Parnell v. Madonna Rehab. Hosp., Inc., 258 Neb. 125, 602 N.W.2d 461 (1999).
The
lien of a physician, nurse, hospital, or other health care provider cannot
exceed the amount the health care provider agreed to accept for the services
rendered to a patient, even if the usual and customary charge for such services
is greater than that sum. Midwest Neurosurgery v. State Farm Ins. Cos., 12
Neb. App. 328, 673 N.W.2d 228 (2004).
3. Miscellaneous
By
perfecting the lien created under this section before the tort-feasor pays
the judgment or settlement to the patient, the health care provider creates
an obligation on the tort-feasor to ensure that the provider's bill will be
satisfied from the funds that the tort-feasor owes to the patient. Midwest
Neurosurgery v. State Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572 (2004).
If
a tort-feasor's insurer impairs a lien created under this section, then the
insurer is directly liable to the health care provider for the amount that
would have been necessary to satisfy the lien. Midwest Neurosurgery v. State
Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572 (2004).
A hospital
lien which attaches prior to a patient's filing for bankruptcy relief is unaffected
by the patient's discharge in bankruptcy. An insurance company breaches its
duty to a hospital not to impair the hospital's rights under its lien by settling
directly with a patient rather than making payment to the hospital. Alegent
Health v. American Family Ins., 265 Neb. 312, 656 N.W.2d 906 (2003).
The
recovery of the full amount owed to a lienholder, less the lienholder's proportionate
share for attorney fees and litigation expenses, operates to fully satisfy
debt owed under this section. National Acct. Sys. of Lincoln v. Glasscock,
247 Neb. 620, 529 N.W.2d 529 (1995).
This section requires a pro
rata reduction of medical provider's lien for any fees due patient's counsel.
In re Guardianship & Conservatorship of Bloomquist, 246 Neb. 711, 523
N.W.2d 352 (1994).
The proper party defendant in a suit to enforce
a hospital lien is generally the party responsible for the patient's injuries,
not that party's insurer. A hospital lien attaches upon admission of the patient
to the hospital for treatment and is thereafter enforceable against the patient,
but perfection is required to enforce the lien against third parties. Upon
perfection of a lien by a hospital, a duty arises on the part of the tort-feasor's
insurer not to impair the hospital's lien, and if such an insurer settles
directly with the injured party despite the existence of a perfected lien,
it has breached that duty and is liable directly to the hospital. At least
substantial compliance with the notice requirements of the hospital lien statute
is necessary to perfect such a lien, and actual knowledge that the hospital
is treating the patient alone is not sufficient. West Neb. Gen. Hosp. v. Farmers
Ins. Exch., 239 Neb. 281, 475 N.W.2d 901 (1991).
The underlying
common-law contractual obligation between a patient and a medical provider
is not affected by a statutory lien. If a patient receives medical services,
he or she is always responsible for payment irrespective of whether there
is a financially responsible tort-feasor against whom a statutory lien can
be asserted in the event of a settlement or judgment in the patient's favor.
The patient's personal liability for medical services remains intact irrespective
of the lien statute. In re Conservatorship of Marshall, 10 Neb. App. 589,
634 N.W.2d 300 (2001).
Under established rules of statutory construction,
chiropractors are excluded by omission as health care professionals entitled
to file a physician lien. Nelsen v. Grzywa, 9 Neb. App. 702, 618 N.W.2d 472
(2000).
A lien that has been perfected under the law of the state
where the hospital service was rendered constitutes a valid lien upon any
award, judgment, or settlement, regardless of where the event which caused
the injury occurred or of the residence of the injured party or the party
causing the injury. AMISUB, Inc. v. Allied Prop. & Cas. Ins. Co., 6 Neb.
App. 696, 576 N.W.2d 493 (1998).