Hospital to submit reasonable and necessary charges to third-party payor of healthcare benefits.

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44-12-3.1. Hospital to submit reasonable and necessary charges to third-party payor of healthcare benefits.

If the hospital receives notification regarding the availability of a third-party payor of healthcare benefits for the injured person, the hospital shall, before filing a lien under §44-12-4, submit to the payor for payment any reasonable and necessary charges for the treatment, care, and maintenance of the injured person, to the extent permitted by law or by any applicable contract, including a preferred provider contract or an insurance policy or plan.

If after filing a lien the hospital receives notification regarding the availability of a third-party payor of healthcare benefits for the injured person, the hospital shall submit to the payor for payment any reasonable and necessary charges for the treatment, care, and maintenance of the injured person, to the extent permitted by law or by any applicable contract, including a preferred provider contract or an insurance policy or plan.

The hospital shall submit such charges to the payor in the same amounts and upon the same terms and conditions under which it submits charges for patients who do not have a claim against another for damages caused by an injury.

If the period prescribed by law or by contract for submitting such charges to the payor has expired through no fault of the hospital or if the payor has refused to pay the charges, the hospital may file a lien or enforce an existing lien.

Source: SL 2019, ch 195, §1.


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