The Role of Health Care Liens in Litigation and Recovery
Third-party liens have increasingly become an issue in resolving mass litigation events. Traditionally, liens in the civil justice system represent a claim by a creditor against a plaintiff's (the debtor's) cause of action. In recent years, Medicare and increasingly other forms of health insurance have been given far more extensive lien rights, particularly with regard to the obligations they are owed by defendants' insurers. Because these rights extend beyond the plaintiff to the plaintiff's lawyer and the defendant, these rights have made resolving these liens a requirement of settlement. Not surprisingly, anecdotal evidence suggests that liens are becoming more frequent. This is potentially problematic if liens become sufficiently burdensome or costly that potential litigants do not pursue cases. In this paper the author examines the different types of health care liens and trends in prevalence, as well as how liens have changed the landscape of claim resolution. The author uses a unique dataset on the resolution of a number of mass compensation events, as well as smaller claims. He finds that health care liens are relatively common in his dataset of mass compensation events. Moreover, he finds some evidence that smaller-value liens are more prevalent among Medicare liens, which is consistent with the hypothesis that Medicare liens' more extensive rights relative to other lien types lead the Center for Medicare Services to pursue more and smaller liens than private lien holders.