{
payment of the
damages
}
judgment or settlement
.
2. Page
3, Line 84 through Page 4, Line 96
:
84
patient for the balance of the charges.
85
{
(5) Notwithstanding Subsection (2), a hospital that is a Medicare provider
may not file
86
a lien if at the time that the hospital submits a patient's claim with Medicare on
behalf of the
87
patient:
88
(a) the patient is covered by Medicare; and
89
(b) the hospital has not established the probable existence of third-party
liability and
90
payment through a judgment or settlement.
91
(6) Notwithstanding Subsection (2), a hospital that is a Medicaid provider may
not file
92
a lien if at the time that the hospital submits a patient's claim with Medicaid on
behalf of the
93
patient:
94
(a) the patient is covered by Medicaid; and
95
(b) the hospital has not established the probable existence of third-party
liability and
96
payment through a judgment or settlement.
}
(5)(a) Subject to Subsection (5)(b).
a hospital shall timely bill Medicare or Medicaid before asserting a hospital lien if
the hospital:
(i) is a Medicare or Medicaid provider; and
(ii) provides services to a Medicare or Medicaid eligible individual.
(b) A hospital is not subject to the provisions of Subsection (5)(a) if the hospital,
within a Medicare or Medicaid billing time frame, is able to establish:
(i) the probable existence of third party liability; and
(ii) prospective or actual payment from a third party that constitutes whole or
partial payment for the hospital's usual, reasonable, and customary charges.
(6) A hospital may assert a lien in an amount of up to 90% of the difference
between the hospital's usual, reasonable, and customary charges and the amount
previously paid by health insurance, Medicare, or Medicaid if:
(i) a hospital has billed and accepted payment from a payer described in
Subsection (4) or (5); and
(ii) the patient obtains a recovery from a third party that constitutes whole or
partial payment of medical expenses caused by the third party.
The motion to amend passed unanimously, with Rep. Gibson absent for the vote.
Spoke against the bill: Dave Gessell, Utah Hospital Association
Spoke for the bill: Charles Thronson, Utah Association for Justice
MOTION: Rep. Biskupski moved to return the bill to the Rules Committee with a
recommendation for interim study.
SUBSTITUTE
MOTION: Rep. Webb moved to adjourn. The motion passed, with Rep. Biskupski, Rep.
Duckworth, Rep. King, and Rep. Painter voting in opposition. Rep. Hansen was
absent for the vote.
Rep. Dunnigan adjourned the meeting at 7:20 p.m.
________________________________
Rep. James Dunnigan, Chair