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Kight v. MCG Health, Inc.

Supreme Court of Georgia

March 2, 2015

KIGHT
v.
MCG HEALTH, INC

Certiorari to the Court of Appeals of Georgia -- 325 Ga.App. 349.

Judgment affirmed.

Charles M. Cork III, Nicholson Revell, Sam G. Nicholson, Harry D. Revell, for appellant.

Hull Barrett, David E. Hudson, Christopher A. Cosper, Robert L. Allgood, for appellee.

Robin F. Clark, Laura M. Shamp, Troutman Sanders, Jaime L. Theriot, Jacob A. Rogers, amici curiae.

MELTON, Justice. All the Justices concur.

OPINION

Page 924

Melton, Justice.

In MCG Health, Inc. v. Kight, 325 Ga.App. 349 (750 S.E.2d 813) (2013), the Court of Appeals held that MCG Health, Inc. (Hospital) was not precluded fro filing a hospital lien, see OCGA § 44-14-470 et seq., in order to collect charges associated with the treatment of Christopher Kight. Specifically, the Court of Appeals found that, as a matter of fact, the trial court erred in its determination that the lien was invalid because there was no debt owing at the time it was filed. Concomitantly, the Court of Appeals held that the trial court's related grant of attorney fees to Kight pursuant to OCGA § 13-6-11 was in error. We granted certiorari in order to determine " [w]hether the [296 Ga. 688] Court of Appeals erred when it reversed the award of partial summary judgment, attorney fees and expenses of litigation to [Kight]." Under the facts of this case, we affirm.

1. In relevant part, the record shows that, following a car wreck caused by an allegedly intoxicated driver, Kight received treatment at MCG.

Kight was a member of the Blue Cross[/Blue Shield] managed health care insurance plan, and the hospital care furnished to Kight for injuries he suffered in the accident was covered under a contract between the Hospital and Blue Cross. Under the contract, the Hospital agreed to discount its billed charges for covered hospital care and accept the discounted amount as " payment in full" for the covered care provided to Blue Cross members. The contract allowed the Hospital to bill Kight directly for deductibles and co-pays owed by Kight to the Hospital, but the Hospital agreed under the contract not to balance-bill Kight for the difference between the Hospital's billed charges and the discounted amount due under the contract.

MCG Health, 325 Ga.App. at 350-351 (1). On March 21, 2007, the Hospital filed a $36,177.68 lien against Kight's cause of action pursuant to OCGA § 44-14-470 for the " reasonable charges" of hospital care furnished to Kight from February 4 to February 20, 2007.[1] At that time, the Hospital had been compensated by insurance payments for the bulk of its discounted charges, but, as found by the Court of Appeals, " the amount still owed to the Hospital under the Blue Cross contract for care furnished from February 4 to February 20 was $261.10 in unpaid discounted payments due from Blue Cross, and $186.48 in unpaid deductibles or co-pays due from Kight." Id. at 352 (1). Following the filing of the lien, Kight continued to receive care, and, as of April 5, 2007, Kight owed the Hospital a total of $863.10 in deductibles or co-pays. The Hospital has modified its lien to reflect this amount, and has stated that this is the only amount that it wishes to recover.[2]

[296 Ga. 689] By considering the purpose of the lien statute, it becomes clear that, based on the facts of this case, the Hospital's lien was valid at the time that it was filed.

At its most basic level, [OCGA ยง 44-14-470 et seq.] recognizes that a hospital is entitled to directly bill the patient for its services and to rely solely on the patient to pay for medical services rendered. To ensure payment to the hospital, the statute grants the hospital a lien against a patient's cause of action. This cause of action refers to the patient's recourse against a tortfeasor for causing the patient's injuries. This recourse is represented by a claim brought against a tortfeasor for personal injuries and associated economic damages, such as a hospital bill. In turn, the tortfeasor, where insured, may look to his insurance company to make liability payments to the patient to cover the patient's economic damages. These liability payments, in turn, are subject to the hospital's lien seeking reimbursement for services directly billed to ...

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