2020 Georgia Code
Title 44 - Property
Chapter 14 - Mortgages, Conveyances to Secure Debt, and Liens
Article 8 - Liens
Part 8 - Hospitals and Nursing Homes
§ 44-14-471. Filing of Verified Statement; Contents; Notice

1. In order to perfect the lien provided for in Code Section 44-14-470, the operator of the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice:
   1. Shall, not less than 15 days prior to the date of filing the statement required under paragraph (2) of this subsection, provide written notice to the patient and, to the best of the claimant's knowledge, the persons, firms, corporations, and their insurers claimed by the injured person or the legal representative of the injured person to be liable for damages arising from the injuries and shall include in such notice a statement that the lien is not a lien against the patient or any other property or assets of the patient and is not evidence of the patient's failure to pay a debt. Such notice shall be sent to all such persons and entities by first-class and certified mail or statutory overnight delivery, return receipt requested; and
   2. Shall file in the office of the clerk of the superior court of the county in which the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice is located and in the county wherein the patient resides, if a resident of this state, a verified statement setting forth the name and address of the patient as it appears on the records of the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice; the name and location of the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice and the name and address of the operator thereof; the dates of admission and discharge of the patient therefrom or with respect to a physician practice, the dates of treatment; and the amount claimed to be due for the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice care, which statement must be filed within the following time period:
      1. If the statement is filed by a hospital, nursing home, or provider of traumatic burn care medical practice, then the statement shall be filed within 75 days after the person has been discharged from the facility; or
      2. If the statement is filed by a physician practice, then the statement shall be filed within 90 days after the person first sought treatment from the physician practice for the injury.
2. The filing of the claim or lien shall be notice thereof to all persons, firms, or corporations liable for the damages, whether or not they received the written notice provided for in this Code section. The failure to perfect such lien by timely complying with the notice and filing provisions of paragraphs (1) and (2) of subsection (a) of this Code section shall invalidate such lien, except as to any person, firm, or corporation liable for the damages, which receives prior to the date of any release, covenant not to bring an action, or settlement, actual notice of a notice and filed statement made under subsection (a) of this Code section, via hand delivery, certified mail, return receipt requested, or statutory overnight delivery with confirmation of receipt.

(Ga. L. 1953, Nov.-Dec. Sess., p. 105, § 2; Ga. L. 1978, p. 1371, § 1; Ga. L. 2002, p. 1141, § 2; Ga. L. 2002, p. 1429, § 2; Ga. L. 2003, p. 140, § 44; Ga. L. 2004, p. 394, § 2; Ga. L. 2006, p. 334, § 2/SB 306.)

The 2002 amendments. The first 2002 amendment, effective July 1, 2002, in the first sentence, inserted ", nursing home, or provider of traumatic burn care medical practice" throughout and substituted "records of the" for "records of such" near the middle. The second 2002 amendment, effective July 1, 2002, rewrote this Code section.

The 2003 amendment, effective May 14, 2003, part of an Act to revise, modernize, and correct the Code, in paragraph (a)(1), deleted "hospital" preceding "claimant's knowledge" in the first sentence and revised punctuation in the second sentence.

The 2004 amendment, effective July 1, 2004, inserted "physician practice," throughout subsection (a); substituted "Shall, not less than 30 days prior to the date of filing the statement required under paragraph (2) of this subsection," for "Within 30 days after the person has been discharged therefrom, shall" in the first sentence of paragraph (a)(1); and, in paragraph (a)(2), substituted "30 days" for "15 days" near the beginning and inserted "or with respect to a physician practice, the dates of treatment" near the end.

The 2006 amendment, effective July 1, 2006, substituted "15 days" for "30 days" in the first sentence of paragraph (a)(1); in paragraph (a)(2), deleted ", no sooner than 30 days after the date of the written notice provided for in this Code section," following "Shall file" near the beginning, added ", which statement must be filed within the following time period:" at the end, and added subparagraphs (a)(1)(A) and (a)(1)(B); and substituted the present provisions of subsection (b) for the former provisions which read "The filing of the claim or lien shall be notice thereof to all persons, firms, or corporations liable for the damages, whether or not they received the written notice provided for in this Code section. The failure to perfect such lien in accordance with this Code section shall invalidate such lien."

- For annual survey of trial practice and procedure, see 56 Mercer L. Rev. 433 (2004).

JUDICIAL DECISIONS

"Best of the claimant's knowledge" standard.

- As for the "best of the claimant's knowledge" standard of O.C.G.A. § 44-14-471(a)(1), the Georgia Court of Appeals, Fifth Division has held that the phrase describes the lienholder's knowledge and imposes upon the lienholder the requirement to exercise at least some degree of diligence in acquiring the information necessary to send the notice. Allstate Fire & Casualty Insurance Company v. Kennestone Hospital, Inc., 348 Ga. App. 335, 822 S.E.2d 832 (2019).

- Trial court erred by dismissing the plaintiff's complaint for failure to state a claim because the plaintiff pled viable claims for fraud, negligent misrepresentation, and civil racketeering based on the defendant filing a medical lien seeking full chargemaster rate or sticker price of the defendant's medical procedures, which did not represent a reasonable charge for the treatment received with the intent to collect more than a reasonable charge for the services rendered to the plaintiff. Clouthier v. Medical Center of Central Georgia, Inc., 351 Ga. App. 883, 833 S.E.2d 584 (2019).

- Hospital's petition failed to allege a cause arising under the hospital lien law against the defendant patient, for the reason that O.C.G.A. § 44-14-471 gives no right of action against the patient to whom hospitalization is furnished, but only against those liable to pay the patient damages; the right created is analogous to the remedy provided by the garnishment laws. Hospital Auth. v. Boyd, 96 Ga. App. 705, 101 S.E.2d 207 (1957).

- A hospital lien not filed within the 30-day statutory time period was enforced against defendants who had actual notice of the lien. Macon-Bibb County Hosp. Auth. v. National Union Fire Ins. Co., 793 F. Supp. 321 (M.D. Ga. 1992).

- Because a patient could have sought recovery of $24,794 from a tortfeasor of a hospital's billed charges incurred for his injuries, the hospital was entitled to assert a lien under O.C.G.A. § 44-14-471(b) for the unpaid portion of those billed charges, even though the patient's managed care insurer was not responsible to pay these charges in full. The court held that Constantine v. MCG Health, Inc., 275 Ga. App. 128, 619 S.E.2d 718 (2005), had been implicitly overruled in part. MCG Health, Inc. v. Kight, 325 Ga. App. 349, 750 S.E.2d 813 (2013), aff'd, 296 Ga. 687, 769 S.E.2d 923 (2015).

- Supreme court overrules Clouthier v. Med. Center of Central Ga., Inc., 351 Ga. App. 883 (2019), and Aguila v. Kennestone Hosp., 353 Ga. App. 17 (2019), to the extent that those cases hold that viable claims for fraud, negligent representation, and violations of the Georgia Racketeer Influenced and Corrupt Organizations Act, O.C.G.A. § 16-14-1 et seq., can be maintained against hospitals that properly file liens based on standard chargemaster rates that reflect true market considerations such as hospital costs. Bowden v. The Medical Center, Inc., Ga. , 845 S.E.2d 555 (2020).

- Summary judgment was improperly denied to the medical center on the plaintiffs' fraud and negligent misrepresentation claims because the center's filing of a lien at the center's chargemaster rate in compliance with Georgia's lien statutes did not amount to making a false representation; and there was nothing fraudulent about the center's using its standard chargemaster rates as the amount claimed to be due for the hospital to perfect the hopsital's lien as the plaintiff could contest the reasonableness of the amount. Bowden v. The Medical Center, Inc., Ga. , 845 S.E.2d 555 (2020).

- In the patient's action against the hospital for fraud, negligent misrepresentation, and violations of the RICO Act, O.C.G.A. § 16-14-1 et seq., arising from a hospital lien that the hospital filed following the hospital's treatment of the patient, the court held that the case was controlled adversely to the hospital by its recent decision in Clouthier v. The Medical Center of Central Ga., 351 Ga. App. 883 (2019) and, therefore, the trial court erred by granting the hospital's motion to dismiss because it did not appear to a legal certainty that the patient would be entitled to no relief under any state of facts that could be proved in support of the patient's claims. The patient alleged that the lien was for the full "chargemaster" rate or "sticker price" which did not represent a reasonable charge for the treatment received. Aguila v. Kennestone Hosp., 353 Ga. App. 17, 836 S.E.2d 179 (2019).

- The grant of summary judgment to a hospital in the hospital's action to perfect a medical services lien under O.C.G.A. § 44-14-471 against an insurance company was affirmed because in spite of the hospital's undisputed exercise of due diligence, the hospital did not know the identity of the tortfeasor or the insurer until after the hospital had filed the lien, so the hospital was not required to send notice to the insurer to perfect the insurer's lien. Allstate Fire & Casualty Insurance Company v. Kennestone Hospital, Inc., 348 Ga. App. 335, 822 S.E.2d 832 (2019).