Harvey v. Centura & Manzanares v. Centura.
2021 CO 65. Nos. 20SC261 & 20SC784. Hospital Lien Statute—Medicare as Secondary Payer—Primary Medical Payer of Benefits—Liability and Casualty Insurance.
September 13, 2021
These cases required the Supreme Court to examine the interplay between Colorado’s hospital lien statute, CRS § 38-27-101 (the Lien Statute), and the federal Medicare Secondary Payer statute, 42 USC § 1395y (2021) (the MSP Statute). Specifically, the Court evaluated whether, under the Lien Statute, a hospital must bill Medicare before it can file a lien against a patient who has been injured in an accident and whose primary health insurance is provided by Medicare.
The Court concluded that when Medicare is a patient’s primary health insurer, the Lien Statute requires a hospital to bill Medicare for the medical services provided to the patient before asserting a lien against that patient. This interpretation is consistent with the Lien Statute’s language, which distinguishes between “the property and casualty insurer” and “the primary medical payer of benefits,” and also reflects the legislature’s intent to protect insureds from abusive liens. Moreover, this interpretation yields no conflict between the Lien Statute and the MSP Statute. Hospital liens are governed by state law, not federal law, and merely enforcing the Lien Statute does not make Medicare a primary payer of medical benefits in violation of the MSP Statute. Accordingly, the decisions in the cases below were reversed.