State Codes and Statutes
Statutes > Nebraska > Chapter52 > 52-40152-401. Lien; scope and operation; exception; reduction, when; claim of lien;notice; priority of claims; access to records.Whenever anyperson employs a physician, nurse, chiropractor, or hospital to perform professionalservice or services of any nature, in the treatment of or in connection withan injury, and such injured person claims damages from the party causing theinjury, such physician, nurse, chiropractor, or hospital, as the case maybe, shall have a lien upon any sum awarded the injured person in judgmentor obtained by settlement or compromise on the amount due for the usual andcustomary charges of such physician, nurse, chiropractor, or hospital applicableat the times services are performed, except that no such lien shall be validagainst anyone coming under the Nebraska Workers' Compensation Act. For personscovered under private medical insurance or another private health benefitplan, the amount of the lien shall be reduced by the contracted discount orother limitation which would have been applied had the claim been submittedfor reimbursement to the medical insurer or administrator of such other healthbenefit plan. The measure of damages for medical expenses in personal injuryclaims shall be the private party rate, not the discounted amount.Inorder to prosecute such lien, it shall be necessary for such physician, nurse,chiropractor, or hospital to serve a written notice upon the person or corporationfrom whom damages are claimed that such physician, nurse, chiropractor, orhospital claims a lien for such services and stating the amount due and thenature of such services, except that whenever an action is pending in courtfor the recovery of such damages, it shall be sufficient to file the noticeof such lien in the pending action.A physician, nurse, chiropractor,or hospital claiming a lien under this section shall not be liable for attorney'sfees and costs incurred by the injured person in securing the judgment, settlement,or compromise, but the lien of the injured person's attorney shall have precedenceover the lien created by this section.Upon a written requestand with the injured person's consent, a lienholder shall provide medicalrecords, answers to interrogatories, depositions, or any expert medical testimonyrelated to the recovery of damages within its custody and control at a reasonablecharge to the injured person. SourceLaws 1927, c. 162, § 1, p. 425; C.S.1929, § 52-401; R.S.1943, § 52-401; Laws 1986, LB 811, § 138; Laws 1995, LB 172, § 1; Laws 2008, LB586, § 1. Cross ReferencesNebraskaWorkers' Compensation Act, see section 48-1,110. Annotations1.Lien attachment2. Usual and customary charges3.Miscellaneous1. Lien attachmentThelien of a service provider under this section attaches at the time the servicesare performed for purposes of the application of this section. In re Conservatorshipof Holle, 254 Neb. 380, 576 N.W.2d 473 (1998).A hospital lienunder this section attaches on a patient's admission to the hospital for treatment.Ehlers v. Perry, 242 Neb. 208, 494 N.W.2d 325 (1993).2.Usual and customary chargesInthis section, the phrase "usual and customary charges" acts as a cap; it preventsthe lien from being an amount greater than what the health care provider typicallycharges other patients for the services that it provided to the injured party.Midwest Neurosurgery v. State Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572(2004).Under this section, the lien is equal to the debt stillowed to the health care provider for its usual and customary charges. MidwestNeurosurgery v. State Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572 (2004).Usual and customary chargesare the charges of the service provider instead of the amount actually collected.Parnell v. Madonna Rehab. Hosp., Inc., 258 Neb. 125, 602 N.W.2d 461 (1999).Thelien of a physician, nurse, hospital, or other health care provider cannotexceed the amount the health care provider agreed to accept for the servicesrendered to a patient, even if the usual and customary charge for such servicesis greater than that sum. Midwest Neurosurgery v. State Farm Ins. Cos., 12Neb. App. 328, 673 N.W.2d 228 (2004).3. MiscellaneousByperfecting the lien created under this section before the tort-feasor paysthe judgment or settlement to the patient, the health care provider createsan obligation on the tort-feasor to ensure that the provider's bill will besatisfied from the funds that the tort-feasor owes to the patient. MidwestNeurosurgery v. State Farm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572 (2004).Ifa tort-feasor's insurer impairs a lien created under this section, then theinsurer is directly liable to the health care provider for the amount thatwould have been necessary to satisfy the lien. Midwest Neurosurgery v. StateFarm Ins. Cos., 268 Neb. 642, 686 N.W.2d 572 (2004).A hospitallien which attaches prior to a patient's filing for bankruptcy relief is unaffectedby the patient's discharge in bankruptcy. An insurance company breaches itsduty to a hospital not to impair the hospital's rights under its lien by settlingdirectly with a patient rather than making payment to the hospital. AlegentHealth v. American Family Ins., 265 Neb. 312, 656 N.W.2d 906 (2003).Therecovery of the full amount owed to a lienholder, less the lienholder's proportionateshare for attorney fees and litigation expenses, operates to fully satisfydebt owed under this section. National Acct. Sys. of Lincoln v. Glasscock,247 Neb. 620, 529 N.W.2d 529 (1995).This section requires a prorata reduction of medical provider's lien for any fees due patient's counsel.In re Guardianship & Conservatorship of Bloomquist, 246 Neb. 711, 523N.W.2d 352 (1994).The proper party defendant in a suit to enforcea hospital lien is generally the party responsible for the patient's injuries,not that party's insurer. A hospital lien attaches upon admission of the patientto the hospital for treatment and is thereafter enforceable against the patient,but perfection is required to enforce the lien against third parties. Uponperfection of a lien by a hospital, a duty arises on the part of the tort-feasor'sinsurer not to impair the hospital's lien, and if such an insurer settlesdirectly with the injured party despite the existence of a perfected lien,it has breached that duty and is liable directly to the hospital. At leastsubstantial compliance with the notice requirements of the hospital lien statuteis necessary to perfect such a lien, and actual knowledge that the hospitalis treating the patient alone is not sufficient. West Neb. Gen. Hosp. v. FarmersIns. Exch., 239 Neb. 281, 475 N.W.2d 901 (1991).The underlyingcommon-law contractual obligation between a patient and a medical provideris not affected by a statutory lien. If a patient receives medical services,he or she is always responsible for payment irrespective of whether thereis a financially responsible tort-feasor against whom a statutory lien canbe asserted in the event of a settlement or judgment in the patient's favor.The patient's personal liability for medical services remains intact irrespectiveof the lien statute. In re Conservatorship of Marshall, 10 Neb. App. 589,634 N.W.2d 300 (2001).Under established rules of statutory construction,chiropractors are excluded by omission as health care professionals entitledto file a physician lien. Nelsen v. Grzywa, 9 Neb. App. 702, 618 N.W.2d 472(2000).A lien that has been perfected under the law of the statewhere the hospital service was rendered constitutes a valid lien upon anyaward, judgment, or settlement, regardless of where the event which causedthe injury occurred or of the residence of the injured party or the partycausing the injury. AMISUB, Inc. v. Allied Prop. & Cas. Ins. Co., 6 Neb.App. 696, 576 N.W.2d 493 (1998).
