38-27-101. Lien for hospital care - definition.

Statute text

(1) Before a lien is created, every hospital duly licensed by the department of public health and environment, pursuant to part 1 of article 3 of title 25, C.R.S., which furnishes services to any person injured as the result of the negligence or other wrongful acts of another person and not covered by the provisions of the "Workers' Compensation Act of Colorado", articles 40 to 47 of title 8, C.R.S., shall submit all reasonable and necessary charges for hospital care or other services for payment to the property and casualty insurer and the primary medical payer of benefits available to and identified by or on behalf of the injured person, in the same manner as used by the hospital for patients who are not injured as the result of the negligence or wrongful acts of another person, to the extent permitted by state and federal law.

(2) If no payers of benefits are identified for the injured person due to lack of insurance, a lien may be created.

(3) If a hospital is notified of a payer of benefits after it creates a lien, the hospital shall make good-faith attempts to submit reasonable and necessary charges for hospital care or other services to the identified payer in the same manner as used by the hospital for patients who are not injured as the result of the negligence or wrongful acts of another person.

(4) After a hospital satisfies the requirements of this section, and subject to this article, the hospital shall have a lien for all reasonable and necessary charges for hospital care upon the net amount payable to the injured person or to his or her heirs, assigns, or legal representatives out of the total amount of any recovery or sum had or collected, or to be collected, whether by judgment, settlement, or compromise, by the person or his or her heirs or legal representatives as damages on account of the injuries.

(5) Nothing in this section authorizes a hospital to collect or attempt to collect money from a person as prohibited by section 8-42-101 (4), 8-43-207 (1)(o), or 10-16-705 (3), C.R.S.

(6) Nothing in this section changes any obligation of the hospital or its agents under the "Colorado Medical Assistance Act", articles 4 to 6 of title 25.5, C.R.S.

(7) An injured person who is subject to a lien in violation of this section may bring an action in a district court to recover two times the amount of the lien attempted to be asserted.

(8) The lien of attorneys- and counselors-at-law created by section 13-93-114 has precedence over and is senior to the lien created under this section. This article 27 does not apply to any hospital charges incurred after the date of any such judgment, settlement, or compromise.

(9) For purposes of this section, "payer of benefits" means:

(a) An insurer;

(b) A health maintenance organization;

(c) A health benefit plan;

(d) A preferred provider organization;

(e) An employee benefit plan;

(f) A program of medical assistance under the "Colorado Medical Assistance Act", articles 4 to 6 of title 25.5, C.R.S.;

(g) The children's basic health plan, article 8 of title 25.5, C.R.S.;

(h) Any other insurance policy or plan; or

(i) Any other benefit available as a result of a contract entered into and paid for by or on behalf of an injured person.

History

Source: L. 67: p. 880, 1. C.R.S. 1963: 86-8-1. L. 90: Entire section amended, p. 574, 72, effective July 1. L. 94: Entire section amended, p. 2805, 577, effective July 1. L. 2015: Entire section amended, (SB 15-265), ch. 260, p. 981, 1, effective August 5. L. 2017: (8) amended, (SB 17-227), ch. 192, p. 705, 6, effective August 9.

Annotations

 

ANNOTATION

Annotations

Law reviews. For article, "The Emerging Law of the Statutory Hospital Lien in Colorado," see 25 Colo. Law. 61 (July 1996).

Based on the plain language in subsections (1) and (9) and because the general assembly used the conjunctive "and" in subsection (1), the general assembly intended to require hospitals to bill at least two insurers when they are identified by an injured person before filing a lien: (1) a property and casualty insurer and (2) a patient's primary medical payer of benefits. Garcia v. Centura Health Corp., 2020 COA 38, 490 P.3d 629; Harvey v. Centura Health Initiatives, 2021 CO 65, 495 P.3d 935.

When medicare is a patient's primary health insurer, the general assembly intended hospitals to bill medicare before filing a lien against the patient. Garcia v. Centura Health Corp., 2020 COA 38, 490 P.3d 629; Harvey v. Centura Health Initiatives, 2021 CO 65, 495 P.3d 935.

Nothing in the legislative history of this statute suggests that the general assembly intended the word "primary" to be interpreted as it is used in the federal medicare secondary payer provisions or that the general assembly intended to exclude medicare beneficiaries from the prerequisite health insurance billing requirement for a hospital lien. The federal definition of medicare as a "secondary payer" does not control the meaning of the statute's phrase "primary medical payer of benefits." Garcia v. Centura Health Corp., 2020 COA 38, 490 P.3d 629; Harvey v. Centura Health Initiatives, 2021 CO 65, 495 P.3d 935.

Statute does not prohibit an assignment of a hospital's right to file a lien nor does it state that only a duly licensed hospital may create the lien. Trevino v. HHL Fin. Servs., Inc., 928 P.2d 766 (Colo. App. 1996), aff'd on other grounds, 945 P.2d 1345 (Colo. 1997).

Valid assignment of hospital's claim to a lien to a collection agency did not render the lien invalid. Trevino v. HHL Fin. Servs., Inc., 928 P.2d 766 (Colo. App. 1996), aff'd on other grounds, 945 P.2d 1345 (Colo. 1997).

This section does not require a hospital enforcing its statutory lien for medical services upon the proceeds of a personal injury settlement to contribute a proportionate share of the attorney fees incurred in obtaining the settlement. Trevino v. HHL Fin. Servs., Inc., 945 P.2d 1345 (Colo. 1997).

Substantial compliance with the hospital lien statute is enough to satisfy the statute's filing and notice provisions. Strict compliance is not necessary. A lienholder substantially complies when it satisfies the statute's purposes through timely actual notice of the lien to those against whom the lienholder attempts to enforce the lien. Wainscott v. Centura Health Corp., 2014 COA 105, 351 P.3d 513.

A claim for relief from a lien violation attaches at the time the complaint is filed. Marchant v. Boulder Cmty. Health, Inc., 2018 COA 126M, 436 P.3d 590.

Applied in Fleet Leasing, Inc. v. District Court, 649 P.2d 1074 (Colo. 1982).