Disclaimer: This article is for informational purposes only and does not constitute legal advice.
Detailed Answer
When you pursue a personal injury claim in New Hampshire, you may accumulate medical bills for treatment related to the accident. Healthcare providers can assert liens against any settlement or judgment to recover the cost of services. Understanding how these liens work and negotiating them effectively can increase your net recovery.
New Hampshire Medical Lien Statute (RSA 507-B)
Under RSA 507-B:4, any provider, hospital, or facility that delivers medical care for injuries allegedly caused by another party may file a lien against the patient’s recovery. The provider must file a certificate of lien with the county superior court where the action is pending within 60 days after the last treatment. (See RSA 507-B:4.)
Identifying and Confirming Liens
Work with your attorney to request a lien search. Obtain billing statements and confirm amounts with each provider. Check whether an insurer or health plan has a subrogation claim or reimbursement right.
Negotiating Liens
Attorneys often negotiate with providers to reduce billed charges in exchange for prompt payment. Common reductions range from 30% to 60% of the billed amount. Written agreements may secure a lower payoff figure or a release of lien upon payment.
Handling Medicare and Medicaid
If Medicare or Medicaid paid medical expenses, federal law requires you to resolve “conditional payments” before settlement. Request a conditional payment report from CMS’s Coordination of Benefits Contractor. Negotiate a Medicare set-aside or obtain a waiver to avoid future liability. (For details see CMS Medicare Secondary Payer.)
Drafting the Settlement Agreement
Ensure the settlement agreement itemizes the lien resolution plan. Allocate portions of the settlement to medical expense repayment, general damages, and attorney fees. Require providers to execute lien waivers upon payment. Then distribute net proceeds to your client.
Helpful Hints
- Request a provider lien statement early in discovery.
- Compare billed charges to usual and customary rates.
- Obtain a Medicare conditional payment summary before mediation.
- Secure lien waivers from each medical provider.
- Document all negotiation offers in writing.