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Are Hospital Liens Against a Minor’s Tort Action Invalid? The Illinois Supreme Court Weighs In.

Usually, when a person suffers some type of injury by no fault of their own, medical bills inevitably rack up.  Sometimes, the injured person is often left bearing much of the costs when his/her health insurance does not cover all of the charges. Or sadly, the patient is left bearing all of the costs when he/she has no health insurance at all. And in many instances, the medical providers simply refuse to bill the person’s health insurance company, opting instead to seek compensation from the Defendant’s insurance policy. They usually do this in the hope that they will obtain more money than what a health insurance company will pay if the injured person wins a lawsuit. In each of these events, medical providers often assert a lien on the personal injury lawsuit so that they will be paid out of the proceeds.

Indeed, when the treatment stems from injuries suffered due to negligent conduct, Illinois law allows medical providers to assert a lien against the monies awarded in personal injury lawsuits. This is called the Health Care Services Lien Act (770 ILCS 23/1 et seq. (West 2012), which permits medical providers to assert a lien on any personal injury claim, which is applied against any “injured party.”  But what happens when the “injured party” is a minor?  It becomes an interesting question because, pursuant to the Family Expense Act (750 ILCS 65/15 (West 2012), the parents of the minor child are liable for the medical expenses of a minor child, not the minor or the minor’s estate.  How then can a medical provider assert a lien against an injured minor for the treatment of that minor’s injuries, when a minor cannot, in fact, be obligated or liable for such expenses? It would seem, then, that both the Health Care Services Lien Act and the Family Expense Act are at odds, which caused the Illinois Supreme Court to take up the question in the case of Akeem Manago, a Deceased Minor, by and though April Pritchett, Mother and Next Friend v. The County of Cook, 2017 IL 121078.

This case was brought by the mother of her minor child for injuries the minor sustained while he was “elevator surfing” on an elevator owned and operated by the Chicago Housing Authority.  The minor was treated for injuries at Stroger Hospital, who in turn, asserted a lien for the cost of such treatment against the minor’s personal injury lawsuit.  The minor did not claim any medical expenses as part of the lawsuit. The trial court ultimately awarded a monetary judgment in favor of the minor.  However, the trial court made no specific award of medical expenses; rather the award was for scarring, pain and suffering and loss of a normal life.  After judgment, upon motion of the plaintiff to extinguish the lien held by Stroger Hospital, the trial court ruled that Stroger was not entitled to assert its lien because:  (1) there was no specific award for medical expenses and (2) since the mother of the minor, who incurs the liability for medical expenses of her minor child under the Family Expense Act, did not assign her cause of action to recover medical expenses to her minor child, there can be nothing to which the lien can attach.  The Appellate Court ultimately upheld the trial courts ruling.

Cook County, on behalf of Stroger Hospital, petitioned the Illinois Supreme Court to review the trial and appellate court’s decision, and the Supreme Court heard the case.  Cook County argued that the trial and appellate courts were incorrect in holding that the lien it asserted for treatment of the minor is not enforceable because the plain language of the Health Care Services Lien Act unambiguous and clearly allows a medical provider to assert a lien against any ‘injured party’s’ cause of action, without mention of the age of the injured party.  Naturally, the minor estate argued that such an interpretation conflicts with the Family Expense Act, and therefore the Health Care Services Lien Act cannot be read in the manner suggested by Cook County.

The Illinois Supreme Court, in its opinion filed on September 21, 2017, agreed with Cook County’s position and reversed the lower courts.  The Court held that there is nothing in the Health Care Services Lien Act’s broad language that suggests its application is limited by either age of the injured party or by the Family Expense Act’s parental liability provision.  Further, it found that if the legislature decided to limit or restrict the Health Care Services Lien Act, it can certainly do so, but by the plain and unambiguous language of the statute, it did not.

The Court’s decision did not attempt to harmonize the Health Care Services Lien Act and the Family Expense Act by considering notions of public policy as the Estate strenuously argued because according to the Court, that is not the duty of the court, but of the legislature.  Instead, it held that absent legislative amendment to restrict such recovery, a statutory health care lien may attach to a minor’s tort recovery. Thus, the Health Care Services Lien Act and the Family Expense Act do not stand at odds based on statutory interpretation or legislative intent, but simply offer two different tools for medical providers to assert their liens.  The Court stated that if the Family Expense Act was intended to be a creditor’s only remedy, it would have expressly stated that the minor’s expenses shall be charged to the parents rather than making them merely “chargeable” to the parents. The Court found that both Acts can coexist and any medical provider or creditor can proceed under both or either of the Acts, whichever is appropriate.  While many may disagree with the inequitable nature of the Court’s decision, this is now the law. Plaintiff’s attorneys will now have to claim medical bills that are in no way attributable to the minor if they want to protect that minor’s bottom line because a medical provider can simply assert a lien for moneys awarded, even if the jury was not even asked to award any money for medical bills.

The Supreme Court’s decision can be found at:  https://www.illinoiscourts.gov/Opinions/SupremeCourt/2017/121078.pdf

— Joseph A. Konrad