SB210INTRODUCED
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SB210
RBGXFMY-1
By Senator Barfoot
RFD: Judiciary
First Read: 04-Mar-25
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5 RBGXFMY-1 02/19/2025 JC (L)lg 2025-813
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First Read: 04-Mar-25
SYNOPSIS:
Existing law provides that a hospital may
recover its charges for treatment of a patient injured
in an accident by filing a lien on any money the
patient receives by settlement with, or judgment
against, the person responsible for the injuries.
If an injured patient is covered by a government
program such as Medicare, this bill would give
hospitals the choice of either filing a claim with the
program or filing a hospital lien. If the hospital
files a lien, the amount of the lien would be tied to
the prospective reimbursement amount of the government
program, plus an additional percentage.
In the case of a patient who has no health care
coverage, the hospital's lien amount would be capped at
the prospective amount that would be reimbursed by
Medicare, plus an additional percentage.
A hospital that files a lien may also choose to
adjust the amount of its claim, based upon the length
of time it takes to receive payment.
This bill would cap the amount a hospital may
recover for treatment from the insurance of a third
party that is liable for the injury when the amount
claimed exceeds the policy limits.
This bill would permit a patient to obtain a
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This bill would permit a patient to obtain a
copy of his or her medical records and an itemized
statement of the charges that support the amount
claimed by the hospital in a lien.
This bill would also make nonsubstantive,
technical revisions to update the existing code
language to current style.
A BILL
TO BE ENTITLED
AN ACT
Relating to hospital liens; to amend Section 35-11-371,
Code of Alabama 1975, to further provide for payment for
treatment of injured patients by requiring hospitals in
certain circumstances to either bill a government health
insurance program or file a lien; to regulate hospital lien
amounts and hospital recovery from third-party insurers; to
require a hospital to substantiate the amount of a lien upon
request by a patient; and to make nonsubstantive, technical
revisions to update the existing code language to current
style.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. Section 35-11-371, Code of Alabama 1975, is
amended to read as follows:
"ยง35-11-371
(a) For the purposes of this section, the following
terms shall have the following meanings:
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terms shall have the following meanings:
(1) GOVERNMENTAL PAYOR. Includes Medicare, Medicaid,
the Children's Health Insurance Program (ALL kids), TRICARE,
Veterans Health Administration, and the Indian Health Service.
(1)(2) HEALTH CARE PAYOR. A health care insurer, health
maintenance organization, or health care service plan
organized under Article 6, Chapter 20, Title 10A, authorized
to provide health care coverage in the state.
(2)(3) SATISFY THE CLAIM. Receipt by the hospital of
either of the following:
a. Full payment for services as billed , subject to
payment for services as regulated under subdivisions (b)(2)
through (3).
b. If the hospital has a contract with the injured
person'spatient's health care payor, payment together with all
credits, discounts, and contractual adjustments that the
patient's bill would be entitled under the contract, including
recoupments, between the hospital and the patient's health
care payor which extinguish the patient's obligation for the
services rendered.
(b) Unless contrary to any law or governmental rule or
regulation of the United States or this state, no hospital
shall perfect a lien as to any injured personpatient who was
covered by a health care payor's policy, until the hospital
submits to the health care payor an accurate and properly
coded claim, or if a contract exists between the hospital and
the health care payor, in the form required pursuant to the
contract, and if there is a failure to satisfy the claim .,
Perfection of a lien shall be as follows may be perfected in
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Perfection of a lien shall be as follows may be perfected in
the manner prescribed for the following situations :
(1) A hospital may perfect its lien as to an injured
personpatient who was covered by a health care payor's policy
that provides primary coverage for the care, if the hospital
takes the steps described in subsection (c), within 20 days
after its receipt of notice of the health care payor's denial
of an accurate and properly coded claim. Failure to satisfy an
accurate and properly coded claim within 45 days of submission
or the subsequent recoupment by the health care payor of
amounts previously paid, which results in a failure to satisfy
the claim, shall be deemed a denial of the claim.
(2) A hospital may perfect its lien as to an injured
person who: (i) was not known to the hospital to be covered by
a health care payor, (ii) was covered by a governmental payor
including Medicare or Medicaid, or(iii) was covered by a
policy not described in subdivision (1), or (iv) has no
coverage from any source, if it takes the steps described in
subsection (c) within 20 days after discharge.
a. If an injured patient's only health care coverage is
a governmental payor, the hospital may: (i) perfect its lien
pursuant to this paragraph, or (ii) bill the government payor
for satisfaction of its charges and any claim for services
billed. If the hospital chooses not to bill the governmental
payor, the hospital's lien shall be limited to the amount of
the governmental payor's prospective reimbursement to the
hospital for treatment of the injury, plus 10 percent of that
amount. In the alternative, the hospital may elect to satisfy
its claim by receiving one of the following applicable
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its claim by receiving one of the following applicable
amounts:
1. Twenty percent of the amount of the lien if the
hospital receives payment within 180 days of filing the lien.
2. Twenty-five percent of the amount of the lien if the
hospital receives payment within 240 days of filing the lien.
3. Thirty percent of the hospital lien if the hospital
receives payment more than 240 days after filing the lien.
b. If an injured patient has no coverage from any
source, the hospital's lien shall be limited to what would be
the amount of the prospective Medicare reimbursement to the
hospital for treatment of the injury, plus 10 percent of that
amount. In the alternative, the hospital may elect to satisfy
its claim by receiving one of the applicable payment amounts
as provided in subparagraphs a.1. through 3.
(3) If the amount of the hospital lien exceeds the
policy limit of a third party's insurance, the maximum amount
of the lien shall be governed by the limits in subparagraphs
(2)a.1. through 3., provided that in no event shall the
hospital's recovery exceed 30 percent of the total policy
limit of a third party's insurance when there is any other
outstanding lien asserted by a health care provider or a
governmental payor.
(3)(4) Where the hospital does not receive evidence of
the injured person'spatient's health care payor until after
the lien provided for by this section has been perfected, the
hospital shall bill the health care payor forthwith but may
retain its lien until satisfaction of the claim. If the claim
is satisfied, the hospital shall release the lien within 10
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is satisfied, the hospital shall release the lien within 10
days.
(c) In order to perfect a lien under this division, the
operator of the hospital shall file with the probate court of
the county in which the hospital is located a verified
statement setting forth the name and address of the patient ,
as it appears on the records of the hospital, the name and
location of the hospital and the name and address of the
operator thereof, the dates of admission and discharge of the
patient therefrom, the amount claimed to be due for the
hospital care, which shall give full credit for any health
care payor payments made, including agreed contractual
adjustments, and to the best of the claimant's knowledge, the
names and addresses of all persons , firms, or corporations
claimed by the injured personpatient, or the legal
representative of the personpatient, to be liable for damages
arising from the injuriesinjury. The claimant shall also
within one day after the filing of the claim or lien, mail a
copy thereof by registered or certified mail, postage prepaid,
for each person, firm, or corporation so claimed to be liable
on account of the injuries, at the addresses so given in the
statement, and to the patient, his or her guardian, or his or
her personal representative at the address given at the time
of admission.
(d) The filing of a claim or lien shall be notice
thereof to all persons, firms, or corporations claimed to be
liable for damages, whether or not they are named in the claim
or lien. Nothing shall be deemed to preclude the hospital from
perfecting its lien outside of the time limits stated in this
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perfecting its lien outside of the time limits stated in this
section through providing actual notice to persons , firms, or
corporations.
(e) The judge of probate shall endorse thereonon the
lien the date and hour of filing, and at the expense of the
county shall provide a hospital lien book with proper index in
which he or she shall enter the date and hour of the filing,
the names and addresses of the hospital, the operators thereof
and of the patient, the amount claimed , and the names and
addresses of those claimed to be liable for damages. The
information shall be recorded in the name of the patient. The
judge of probate shall be paid one dollar ($1) as his or her
filing fee for the filing.
(f) No more than 30 days after receipt of a written
request by a patient or the patient's representative, a
hospital shall provide a copy of the patient's medical record
and a statement itemizing each service along with each charge
that comprises the amount claimed on the lien ."
Section 2. This act shall become effective on October
1, 2025.
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