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Preying on Pain: A Legal and Bioethical Analysis of How Hospitals Profit from Placing Hospital Liens on Medicaid Patients' Accident Recoveries

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title
Preying on Pain: A Legal and Bioethical Analysis of How Hospitals Profit from Placing Hospital Liens on Medicaid Patients' Accident Recoveries
author
Servis, Remy O
abstract
Hospital lien laws were codified into state statutes in the early to mid-twentieth century, during a time when large-scale, uniform health insurance coverage was not yet commonplace in the United States, and hospitals needed protection from the financial risk of providing costly emergency care to uninsured or insolvent patients. These statutory liens give a hospital a nonpossessory lien interest in a judgment or monies accruing to a patient who has recovered a settlement from a third-party tortfeasor after an accident. A hospital has the legal right to reject a lesser payment under a Medicaid patient’s coverage scheme in favor of pursuing a larger payout from the settlement proceeds. This thesis proposes that these laws have unacceptable legal and ethical implications for patients with public insurance coverage. They directly harm the patient by eschewing the entire purpose of their coverage, which is meant to provide equitable access to care. I examine states that are at the forefront of progressive caselaw to curb hospitals’ rights to place these liens, and suggest ways in which states with more hospital-friendly laws can follow in their footsteps. I also analyze the inequity of these hospital lien laws from a bioethical perspective, with particular focus on the importance of reprioritizing distributive and compensatory justice in this context.
subject
compensatory justice
distributive justice
hospital lien
insurance settlement
Tennessee
contributor
King, Nancy M. P. (advisor)
Hall, Mark (committee member)
Cardi, Jonathan (committee member)
date
2023-01-24T09:35:35Z (accessioned)
2023-01-24T09:35:35Z (available)
2022 (issued)
degree
Bioethics (discipline)
identifier
http://hdl.handle.net/10339/101766 (uri)
language
en (iso)
publisher
Wake Forest University
type
Thesis

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