Since 2013, when the North Carolina legislature amended the Hospital Licensure Act to include Section 131E-91(c), there has been some debate as to what, if any, effect the language of subsection (c) may have on a healthcare provider’s ability to pursue a statutory hospital lien under N.C.G.S. §44-49. While 131E-91(c) never mentions a hospital lien, some attorneys (plaintiffs’ attorneys and attorneys representing liability carriers) have taken the position that it forces a healthcare provider to file charges to health insurance and abandon its lien prior to the expiration of a health insurer’s timely filing period, or else the provider will waive any right to receive payment on its bill.
The North Carolina Court of Appeals recently examined the interplay of these two statutes in a reported case filed June 18, 2019, Sykes v. Vixamar (COA18-525). The issue before the Court was “[W]hether Section 131E-91(c) prevents a hospital from choosing to rely solely on a medical lien on a future liability judgment, rather than also billing the patient’s health insurer.” The Court held that the hospital may choose between filing charges to a patient’s health insurer or collecting from a liability settlement using a statutory medical lien. The Court further explains that Section 131E-91(c) is “not intended to force hospitals to bill health insurers when other, alternative sources of payment also are available to satisfy the debt.”
The Court’s decision in Sykes makes it clear that a medical lien is valid even if a hospital chooses to forgo filing a claim to a patient’s health insurer, and the law supports the hospital’s ability to decide which avenue for payment it will pursue.