Disclaimer
This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney for guidance tailored to your situation.
Detailed Answer
Understanding Medical Liens in New York
In New York, health care providers and hospitals can assert a lien on personal injury recoveries under Public Health Law § 2805-l. This lien secures payment for medical services to treat accident-related injuries. Before negotiating, confirm the lien’s validity, timing, and scope.
Key Negotiation Strategies
- Audit the Bill: Request a full itemized statement. Look for duplicated charges, excessive unit costs, or services unrelated to the accident. Providers must justify each entry.
- Compare Fee Schedules: Reference Medicare, Medicaid, or workers’ compensation fee schedules to argue for a reduction. Many courts find these government rates reasonable benchmarks.
- Challenge Statutory Compliance: Under PHL § 2805-l, providers must file their lien within specific deadlines. A late or incomplete filing could invalidate or reduce the lien.
- Leverage Attorney-Client Discounts: Medical providers often agree to reduced rates when informed that payment stems from a contingent-fee settlement. Highlight your attorney’s duty to preserve recovery for the client.
- Offer Structured Settlement Payments: Spread payments over time. Providers may accept a lower total if they receive guaranteed periodic payments.
- Negotiate a Percentage Cap: Cap the lien at a percentage of net recovery after attorneys’ fees and litigation costs, rather than the full gross amount.
- Document Medical Necessity: Provide clear medical records showing each service’s necessity. Unnecessary or overly aggressive treatment is often negotiable.
- File a Motion to Reduce: If informal talks stall, you can petition the court to reduce or invalidate the lien under CPLR 5015(a) for excusable neglect or improper filing.
- Use a Neutral Mediator: Engage a mediator experienced in lien disputes to bridge gaps and craft creative payment solutions.
Helpful Hints
- Start negotiations early to avoid hard deadlines.
- Maintain organized records: medical bills, correspondence, and court filings.
- Get all agreements in writing to prevent future disputes.
- Be aware of the client’s net recovery goals when negotiating percentages.
- Consider grouping multiple liens for a single negotiation session to maximize leverage.
- Confirm that any settlement fund disbursement plan accommodates agreed payment structures.