The Illinois Health Care Services Lien Act (770 ILCS 23/1 et seq.) was put into effect to essentially ensure that medical providers are paid for their services provided without taking the entire settlement amount received by a Plaintiff for their injury claim. There are many different aspects of the Act to consider when handling liens relating to an injury claim upon settlement.
First of all in order for a health care lien to be considered legally enforceable, service of the lien must be made by registered mail, certified mail, or in person to both “the injured person and the party against whom the claim or right of action exists.” Emphasis added. Also, if a medical provider fails or refuses to comply with a written request and medical authorization signed by the patient or patient’s representative requesting (1) a written statement of the nature and extent of the injuries sustained, (2) the “treatment, care or maintenance given or furnished for the injured person,” and (3) the history, if any, as provided by the injured person as to how the injuries were sustained, the lien is considered null and void.
Secondly, you must determine what type of lien you have received. There are two types of liens defined by the Illinois Health Care Services Lien Act.
- Health Care Professional: means any individual in any of the following license categories: licensed physician, licensed dentist, licensed optometrist, licensed naprapath, licensed clinical psychologist, or licensed physical therapist. (770 ILCS 23/5)
- Health Care Provider: means any entity in any of the following license categories: licensed hospital, licensed home health agency, licensed ambulatory surgical treatment center, licensed long-term care facilities, or licensed emergency medical services personnel. (770 ILCS 23/5)
The type of lien will determine the amount each provider/professional is owed out of your settlement amount. According to the Act, no health care professional or provider can take more than 40% of the total amount of the final settlement received. Each health care provider is required to proportionately share the 40% allotted from the final settlement amount with 20% shared by the Health Care Professionals and 20% to be shared by Health Care Providers as defined above. However, in the event that there are only liens from either a Provider or Professional as listed above, no more than 1/3rd of the settlement will be distributed among the Providers/Professionals.
The amount paid to each lienholder is determined not only by the definitions listed above, it is also distributed according to what is called the “pro rata” share. The “pro rata” share goes even further and determines what percentage of the 20% that is shared by each Provider or Professional will be given to each based upon the amount of their total lien.
This is part of the job of your lawyer. It can turn into quite a complicated formula and often a computer spreadsheet is utilized to figure this out “at the end” of your case after all treatment is done and the settlement is accomplished.
While the Health Care Services Lien Act specifies how much of your settlement each Provider and Professional is entitled to receive, the act DOES NOT require that the Provider or Professional excuse any remaining amounts that are not covered by your settlement. This means that any amounts owed will become your responsibility after settlement. A personal injury attorney who is handling your claim can try to negotiate with the Provider or Professional to reduce these amounts on your behalf to prevent you from paying out-of-pocket for your treatment.
Call the Law Office of Philip J. Berenz, CPA, JD today at 312-888-6058 if you or someone you know has questions about or needs help with medical liens or any unpaid medical debt relating to a personal injury.
Let our many years of experience do the work for you to take care of your medical debt due to your personal injury.
A Chicago Personal Injury Lawyer like me can help you through the entire process.