Hospital and Provider Liens vs. Insurer Claims in Missouri

By the FigureMyTax Editorial Team · How we calculate

A Missouri hospital, clinic or practitioner has a lien on your claim for reasonable charges. It is effective only if certified-mail notice is sent before any payment, and a payer who ignores it is liable only for the amount that can be satisfied out of 50 percent of the money due to you after your attorney's liens and prior liens.

The lien

RSMo 430.230 gives a public hospital, or a private hospital, clinic or other institution supported in whole or in part by charity, a lien on your claim against the person who injured you for the cost of its services, at reasonable rates and customary charges for X-ray, laboratory, operating room and medication services. It does not apply to workers' compensation. Clinics, health practitioners and other institutions have the same rights (430.225).

Notice

The lien is not effective unless written notice with your name and address, the accident date, the provider and the person alleged to be liable is sent by certified mail, return receipt requested, to the person liable and to any known insurance carrier before any payment to you or your attorney (430.240).

The 50 percent limit and sharing

A person who pays after notice without paying the provider remains liable, for one year after the provider learns of the settlement, for the amount that can be satisfied out of 50 percent of the money due to you after attorney's liens, workers' compensation liens and prior liens (430.250). If several providers' liens exceed 50 percent of the net proceeds, they share up to 50 percent in proportion to their claims. Net proceeds means the amount remaining after contractual attorney fees, if any, and other expenses of recovery.

Releasing you and payment

A provider that elects to receive benefits under the statute releases you from further liability on the cost of the services to that point, and an insurance carrier may pay a provider directly if you authorize it and do not challenge the charges (430.225(4) and (5)).

How an insurer's claim differs

A health plan's claim is not a provider lien; see our post on health plan subrogation. MO HealthNet and Medicare follow their own rules; see the Medicare and MO HealthNet post. Enter each claim in the Missouri medical lien calculator.

This is general information, not legal advice, and the state comparisons above are illustrative, not an exhaustive survey. Confirm how Missouri's rules apply to your specific case with a licensed Missouri attorney.