Over 40 states and the District of Columbia have enacted some form of a medical lien statute. See 152 Am. Jur. Trials § 265 (2017) (noting that Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin have enacted medical lien statutes). Often, these statutes are “limited to the reasonable value of the services rendered by the medical service provider.” As such, cases involving medical liens frequently raise the issue “of what constitutes a reasonable amount” for medical services. This, in turn, has opened the door to discovering providers’ closely guarded reimbursement rates.
In re North Cypress Medical Center Operating Co.
For example, in In re North Cypress Medical Center Operating Co., the Texas Supreme Court confirmed the discoverability of reimbursement rates. No. 16-0851, 2018 WL 1974376 (Tex. Apr. 27, 2018).
The case involved a dispute between a patient and hospital. The hospital treated the uninsured patient and billed her at its chargemaster rates. Pursuant to Texas law, the hospital filed a lien for the billed amount, and the patient filed suit for declaratory judgment that the “charges were unreasonable and [the hospital’s] lien invalid to the extent it exceeds a reasonable and regular rate for services rendered.” Id. at *1.