Medical Bills and Health Care Liens in Virginia Beach, VA Statutory Lien Ceilings and Subrogation Limits

The statutory lien ceilings

Virginia Code 8.01-66.2 sets the maximum amounts a provider may claim as a lien against a recovery. A hospital or nursing home is limited to $2,500. Each physician, nurse, physical therapist or pharmacy is limited to $750. Each emergency medical services provider or agency is limited to $200. Those figures are ceilings on the lien, not on the bill, so a five-figure hospital charge does not translate into a five-figure lien under this section.

Virginia Code 8.01-66.3 then subordinates those liens to the injured person's attorney's claim against the recovery. The ordering is statutory rather than negotiable, and it changes what a distribution looks like.

Notice is a condition, not a courtesy

Virginia Code 8.01-66.5 requires written notice of the lien before a lien under Virginia Code 8.01-66.2 or 8.01-66.9 is created. A provider that never gives the required notice has not perfected the lien the statute would otherwise allow. That single requirement resolves a meaningful share of the lien disputes that arise at the end of a claim, which is why the correspondence file should keep every notice with its date.

The same section carries specific timing for the Commonwealth's medical assistance program. Notice to the Department of Medical Assistance Services must be given within sixty days of filing suit or within twenty-one days of learning of the department's interest, and the department is to respond within sixty days.

The Commonwealth's lien works differently

Virginia Code 8.01-66.9 gives the Commonwealth a lien for the total amount it paid on behalf of the injured person, and that lien is not subject to the ceilings in Virginia Code 8.01-66.2. It is inferior to attorney fees and costs but superior to the other liens in the chapter, and the court may reduce and apportion it. A file with Medicaid involvement therefore has a different arithmetic than one without, and the reduction and apportionment authority is a reason for the court to see the numbers rather than for the parties to assume them.

Health insurers cannot take the recovery

Virginia Code 38.2-3405 prohibits a health or medical insurance policy, subscription contract or plan from containing a provision that subrogates the insurer to the insured's recovery for personal injury, and bars requiring the insured to agree to pay back benefits from such a recovery. The section carves out workers' compensation and federal or state programs. That rule removes an entire category of claim against a settlement that would exist in many other states, and it is worth reading the plan documents against rather than assuming a demand letter is enforceable.

Explanations of what a particular plan may or may not recover are legal questions about that plan, and this page does not answer them.

First-party benefits, where they were purchased

Virginia Code 38.2-2202 requires an auto policy to carry boldface notice of the availability of medical expense benefits up to $2,000 per person for expenses incurred within three years of the accident, and income loss benefits up to $100 per week for up to one year. Those coverages are optional and modest, and whether they were bought is answered by the declarations page rather than by memory. Where they exist, they pay without regard to which driver was at fault, which can matter early while liability is unresolved.

Getting the bills and records in a usable form

Virginia Code 8.01-413 requires health records to be furnished within thirty days after a written request from the patient, the patient's attorney, an executor or administrator, or an authorized insurer. It makes properly authenticated copies and printouts admissible in the same manner as originals, permits a subpoenaed provider to comply by mailing authenticated copies to the clerk, and makes the requesting party liable for the provider's reasonable charges for maintaining, retrieving, reviewing, preparing, copying and mailing what is produced. Itemized statements are more useful than balance summaries, because a lien analysis depends on which category of provider rendered which service.

Why the fault rule reaches the bills too

A recovery is what liens attach to, so Virginia's contributory negligence doctrine sits upstream of every calculation on this page. Where the injured person's own carelessness proximately contributed to the collision, the claim can be barred entirely rather than reduced, and there is then nothing for a lien to reach. The contributory negligence page explains that doctrine and the last clear chance page covers the exception.

Settlement structure matters as well. Virginia Code 8.01-35.1 provides that a good-faith release given to one of several persons liable for the same injury does not discharge the others unless it says so, reduces the claim against the others by the stipulated amount or the consideration paid, whichever is greater, keeps the release out of evidence while allowing the court to consider it, and discharges the released party from contribution liability. The underinsured motorist page covers how that reduction interacts with a later claim under the injured person's own policy.

The above is general information about Virginia's lien and subrogation statutes, not legal advice about any bill, lien or settlement; those questions belong with the attorney advertising on this site.