Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney to discuss your specific situation.
Detailed Answer
Understanding Medical Liens under Maryland Law
In Maryland, health care providers can assert a lien against any personal injury settlement or award to secure payment for services. This is governed by Md. Code, Health-Gen. § 19-214 (see Md. Code, Health-Gen. § 19-214). A valid provider lien attaches when a provider gives written notice to your attorney or you, usually within 90 days of first providing care.
Verifying and Quantifying Outstanding Bills
1. Request an itemized statement from each medical provider. 2. Confirm the dates of service and types of treatment. 3. Compare billed charges with usual and customary rates in your region. 4. Identify any pending Medicaid or Medicare subrogation claims. Federal law may require reimbursement from any settlement for those programs.
Negotiating Lien Reductions
Maryland courts and many providers negotiate lien reductions to maximize your net recovery. Common strategies include:
- Arguing that billed charges exceed fair market value or typical insurance payments.
- Pointing to provider discounts or write-offs in similar cases.
- Offering a lump-sum payment in exchange for a lien waiver.
Liens held by Medicaid or Medicare may have strict federal formulas. Work with your attorney to obtain a final demand letter and explore any allowable reductions under federal regulations (see 42 C.F.R. Part 411 for Medicare).
Allocating Settlement Funds
Once you finalize a settlement, follow this priority for distribution:
- Attorney’s fees and litigation costs (subject to any fee agreement).
- Valid provider liens under Md. Code, Health-Gen. § 19-214.
- Medicare/Medicaid subrogation or other third-party repayment obligations.
- Your net recovery.
Your attorney should obtain lien releases or waivers in writing. Ensure each provider files a satisfaction of lien with the court or submits a release letter.
Helpful Hints
- Gather itemized bills early. Early documentation speeds up negotiations.
- Check Maryland’s maximum allowable fee schedules (if applicable) to strengthen reduction requests.
- Confirm deadlines under Md. Rule 2-647 for filing lien satisfactions in court.
- Maintain a settlement disbursement worksheet to track payees and amounts.
- Keep open communication with your attorney and providers to prevent surprise claims.
- Consult your attorney before disbursing any funds to ensure compliance with all lien obligations.