Chapter 55 of the Texas Property Code gives a hospital that provides emergency medical care to an uninsured accident victim a lien upon the liability insurance of any negligent individual who caused the accident and resulting injuries. Sounds good so far. If you show up at a Texas emergency room within 72 hours of an accident in need of emergency medical care the hospital must treat you regardless of your ability to pay for the accident related medical treatment. In exchange for this obligation to render emergency medical care to accident victims the hospitals received the right to file a Chapter 55 lien against applicable liability insurance. Still sounds okay. The problems arise from the affect of the lien on individual patients and the way in which some hospitals abuse the lien law.
Chapter 55 gives the hospital a lien in the amount of the “usual and customary” charges for the emergency medical services. Therein lies the source of the problem. Most hospitals “usually and customarily” charge several times the amount that most in the medical profession would consider reasonable. In fact, studies published in reputable medical journals have repeatedly concluded that hospital emergency rooms regularly charge approximately 250% of the reasonable amount. The problem is so rampant that the inflated rate has become the “usual and customary” rate. This results in a huge windfall to the hospital when it renders medical care to an accident victim whose circumstances are covered by liability insurance. The hospitals argue that they must recover this inflated amount when there is liability insurance to offset the many instances where they render emergency medical care without compensation. While this argument makes sense system wide it is small consolation to the Texas auto accident victim who is injured by a negligent driver covered by a Texas $25,000 minimum limits policy and receives $10,000 worth of emergency medical care only to see the hospital file an inflated hospital lien in the “usually and customary” amount of $25,000 and take the entire liability policy proceeds.
The problem is further aggravated by the practice of many hospitals to refuse to bill the private health insurance of auto accident victims in hopes of recovering inflated charges by filing a hospital lien. Chapter 146 of the Texas Practices and Remedies Code requires hospitals to bill the private health insurance of auto accident victims and provides penalties for the failure to do so. Nonetheless, many Texas hospitals knowingly continue to file their inflated liens and refuse to bill the private health insurance of auto accident victims with no excuse or justification other than naked greed. Only when the exasperated auto accident victim hires an attorney and presses the hospital will many hospitals release their inflated liens and file on the patients’ private health insurance as required by law.
For more information contact a Tyler Injury Attorney today.