A. The administration is entitled to a lien for the charges for hospital or medical care and treatment of an injured person for which the administration or a contractor is responsible, on any and all claims of liability or indemnity for damages accruing to the person to whom hospital or medical service is rendered, or to the legal representative of such person, on account of injuries giving rise to such claims and which necessitated such hospital or medical care and treatment. The member or the member’s legal representative must provide written notice to the administration within twenty calendar days after the commencement of a civil action or other proceeding to establish the liability of any third party or to collect monies payable from accident insurance, liability insurance, workers’ compensation, health insurance, medical payment insurance, underinsured coverage, uninsured coverage or any other first or third party source.

Terms Used In Arizona Laws 36-2915

  • Action: includes any matter or proceeding in a court, civil or criminal. See Arizona Laws 1-215
  • Administration: means the Arizona health care cost containment system administration. See Arizona Laws 36-2901
  • Contract: A legal written agreement that becomes binding when signed.
  • Contractor: means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers. See Arizona Laws 36-2901
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Department: means the department of economic security. See Arizona Laws 36-2901
  • Director: means the director of the Arizona health care cost containment system administration. See Arizona Laws 36-2901
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • including: means not limited to and is not a term of exclusion. See Arizona Laws 1-215
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Member: means an eligible person who enrolls in the system. See Arizona Laws 36-2901
  • Noncontracting provider: means a person who provides health care to members pursuant to this article but not pursuant to a subcontract with a contractor. See Arizona Laws 36-2901
  • Person: includes a corporation, company, partnership, firm, association or society, as well as a natural person. See Arizona Laws 1-215
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Special health care district: means a special health care district organized pursuant to Title 48, Chapter 31. See Arizona Laws 36-2901
  • Writing: includes printing. See Arizona Laws 1-215

B. In order to perfect a lien granted by this section, the director or the director’s authorized representative, before or within sixty days from the date of notification to the administration of the hospital discharge or rendering of medical care and treatment, shall record in the office of the recorder of the county in which the injuries were incurred a verified statement in writing setting forth the name and address of the patient as they appear on the records of the administration, the name and address of the administration, the dates of admission to and discharge of the patient from the hospital or the dates on which medical care and treatment were provided to the patient, the amount estimated to be due for hospital or medical care and treatment, and, to the best of the director’s knowledge, the names and addresses of all persons, firms or corporations and their insurance carriers alleged by the injured person or that person’s legal representative to be liable for damages arising from the injuries for which he was hospitalized or for which medical care and treatment were provided. However, the director or the director’s authorized representative is not required to include the address of the patient in the verified statement if the administration’s records indicate that the patient’s injuries may have resulted from an offense against the patient as defined in section 13-105. The director or the director’s authorized representative, within five days after recording the lien, shall mail a copy of the lien, postage prepaid, to the patient and to each person, firm or corporation, including insurance carriers, alleged to be liable for liability or indemnity damages, at the address given in the statement. The recording of the lien is notice of the lien to all persons, firms or corporations, including insurance carriers, liable for liability or indemnity damages, whether or not they are named in the lien.

C. The recorder shall endorse on a lien recorded as provided by this section the date and hour of receipt and such facts as are necessary to indicate that it has been recorded.

D. The lien may be assigned in whole or in part to a contractor that is responsible for hospital or medical services.

E. The director shall establish by rule procedures for a contractor and a noncontracting provider to notify the administration concerning the delivery of hospital or medical services to a person who may have claims for damages.

F. Notwithstanding any other law, a lien or claim provided for by this article has priority over a lien of the department pursuant to Section 36-596.01, a lien of the counties pursuant to section 11-291, a health care provider lien pursuant to Title 33, Chapter 7, Article 3 and a claim against a third party payor. A lien of the department of economic security pursuant to Section 36-596.01, a lien of a special health care district pursuant to Section 48-5541.01, subsection N and a lien of the counties pursuant to section 11-291 has priority over a health care provider lien pursuant to Title 33, Chapter 7, Article 3 and a claim against a third party payor.

G. A lien authorized pursuant to this chapter may be amended to reflect current charges. However, if the administration is given notice of an impending settlement of the member’s claim at least fifteen working days before the final settlement of that claim, the lien may not be amended after the time of final settlement.

H. A public entity shall compromise a claim it has pursuant to this section or section 11-291, 12-962, 36-596, 36-596.01, 36-2903, 36-2935 or 36-2956 if, after considering the factors listed in subsection I of this section, the compromise provides a settlement of the claim that is fair and equitable.

I. In determining the extent of the compromise of the claim required by subsection H of this section, the public entity shall consider the following factors:

1. The nature and extent of the patient’s injury or illness.

2. The sufficiency of insurance or other sources of indemnity available to the patient.

3. Any other factor relevant for a fair and equitable settlement under the circumstances of a particular case.

J. Notwithstanding any other law, for the purpose of recovering monies from third party payors as provided by this section, a lien that includes a cover sheet pursuant to subsection K of this section and that is filed by an entity under contract with the administration, a health plan or a program contractor, or the authorized representatives of these entities, is considered filed by the state for the purposes of payment of county recorder fees pursuant to section 11-475, subsection A, paragraph 2.

K. A health plan, a program contractor, an entity under contract with the administration or an authorized representative of the health plan, program contractor or entity shall include a cover sheet, as prescribed by the administration, when filing a lien on behalf of the administration pursuant to this section. The cover sheet shall be signed by the director on the administration’s letterhead with the statutory authority of the health plan, program contractor, entity or authorized representative of the health plan, program contractor or entity to file a lien on behalf of the administration.