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Legal Memorandum: Medicare and IN Hospital Lien Statute

Issue: Do federal Medicare regulations have a broader application than the Indiana hospital lien statute?

Area of Law: Government Programs and Benefits, Healthcare & Pharmaceutical Law Compliance
Keywords: Medicare regulations; Federal regulation is broader; Medical provider or supplier
Jurisdiction: Indiana
Cited Cases: None
Cited Statutes: Ind. Code § 32-33-4-3; 42 C.F.R. § 411.50(b)
Date: 03/01/2005

The Indiana Hospital Lien statute provides for a lien for medical services as follows:

A person, a firm, a partnership, an association, a limited liability company or corporation maintaining a hospital in Indiana . . . has a lien for all reasonable and necessary charges for hospital care, treatment, and maintenance of a patient . . . upon any cause of action, suit, or claim accruing to the patient . . . because of the illness or injuries that . . . gave rise to the cause of action, suit or claim; and . . . necessitated the hospital care, treatment and maintenance.

Ind. Code § 32-33-4-3.  Under the federal Medicare regulation, a “medical provider or supplier” can submit a claim to Medicare for payment if it does not reasonably expect prompt payment of the hospital bills from the applicable insurance carrier.  42 C.F.R. § 411.50(b).

There are no reported cases that compare the “medical provider or supplier” wording in the Medicare regulation to the analogous definition in any state’s hospital lien statute.  A simple comparison of the statutory wording, however, makes it apparent that the federal regulation is broader.  Whereas the state law limits lien rights to “reasonable and necessary charges,” the federal regulation has no explicit “reasonable and necessary” requirement.  Further, the state law limits the lienable charges to “hospital care, treatment, and maintenance of a patient.”  It would appear that the legislative intent is that the word “hospital” modifies the all three of the words “care, treatment and maintenance.”  By exclusion, then, non-hospital services are not lienable.  Finally, the federal […]

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