McAllen Hospitals, L.P. D/B/A McAllen Medical Center v. State Farm County Mutual Insurance Company of Texas

433 S.W.3d 535, 57 Tex. Sup. Ct. J. 579, 83 U.C.C. Rep. Serv. 2d (West) 683, 2014 WL 1998245, 2014 Tex. LEXIS 394
CourtTexas Supreme Court
DecidedMay 16, 2014
Docket12-0983
StatusPublished
Cited by23 cases

This text of 433 S.W.3d 535 (McAllen Hospitals, L.P. D/B/A McAllen Medical Center v. State Farm County Mutual Insurance Company of Texas) is published on Counsel Stack Legal Research, covering Texas Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McAllen Hospitals, L.P. D/B/A McAllen Medical Center v. State Farm County Mutual Insurance Company of Texas, 433 S.W.3d 535, 57 Tex. Sup. Ct. J. 579, 83 U.C.C. Rep. Serv. 2d (West) 683, 2014 WL 1998245, 2014 Tex. LEXIS 394 (Tex. 2014).

Opinion

Justice LEHRMANN

delivered the opinion of the Court.

To assist hospitals with securing payment for medical services provided to accident victims, Texas Property Code chapter 55 (the Hospital Lien Statute) allows a hospital to file a lien on a patient’s cause of action against a person whose negligence caused the injury that necessitated the patient’s treatment. If the hospital’s charges secured by a proper lien are not “paid” within the meaning of the statute, any release of the patient’s cause of action is invalid. In this case, two patients treated at the petitioner’s hospital settled with the negligent third party. That party’s liability insurer made the settlement checks jointly payable to the patients and the hospital and delivered the checks to the patients, who deposited them without the hospital’s endorsement. The issue presented is whether the hospital’s charges were “paid” under the Hospital Lien Statute and the Uniform Commercial Code even though the hospital never received notice that the settlement funds had been delivered to the patients and were never reimbursed for the treatment costs. We hold that they were not.

But this does not end the inquiry. Although failure to “pay” the hospital invalidates the releases of the patients’ *537 negligence causes of action, the question remains whether the hospital may enforce its lien by suing the negligent person or his liability insurer directly. However, this issue was neither raised in the underlying summary judgment motion nor argued on appeal. As a result, we may not decide it. Accordingly, we reverse the court of appeals’ judgment and remand the case to the trial court for further proceedings consistent with this opinion.

I. Background

Jose Gil and Melinda Hernandez were involved in a car accident with Carlos Be-navidez, who was insured by State Farm County Mutual Insurance Company of Texas (State Farm). McAllen Hospitals, L.P. d/b/a McAllen Medical Center (the Hospital) treated Gil and Hernandez for their injuries. The cost of treatment totaled $53,564 for Gil and $1,281 for Hernandez. To secure payment, the Hospital filed hospital liens under chapter 55 of the Texas Property Code. The validity of those liens is not in dispute.

Gil and Hernandez settled with Benavi-dez for $5,200 and $2,100, respectively, and released their claims against him. The Hospital was not a party to the releases, nor was it informed the parties had settled. State Farm, aware of the Hospital’s liens, informed Gil that he was responsible for paying the Hospital for its services out of the settlement funds. 1 State Farm issued Gil’s settlement check payable to “Jose Antonio Gil & Rafaela Balderas, Individually and as husband and wife & McAllen Medical Center,” and issued Hernandez’s check payable to “Melinda De La Garza Hernandez, a Single Individual & McAllen Medical Center.” State Farm sent the checks to Gil and Hernandez without notifying the Hospital. Both Gil and Hernandez deposited their settlement checks without the Hospital’s endorsement. The Hospital’s charges for treating Gil and Hernandez remain outstanding.

The Hospital sued State Farm to enforce its hospital liens, seeking to recover the outstanding treatment costs up to the amount of the settlements. 2 In response, State Farm contended that it met its obligation to pay the Hospital under the Hospital Lien Statute by making the cheeks payable to the Hospital as a copayee. After considering competing cross-motions, the trial court granted summary judgment for State Farm. The court of appeals affirmed. 433 S.W.3d 575, 2012 WL 5292926.

II. Discussion

The Texas Legislature passed the Hospital Lien Statute “to provide hospitals an additional method of securing payment for medical services, thus encouraging the prompt and adequate treatment of accident victims” and reducing hospital costs. Bashara v. Baptist Mem’l Hosp. Sys., 685 S.W.2d 307, 309 (Tex.1985). Under the Hospital Lien Statute, a hospital has a lien on the cause of action of a patient “who receives hospital services for injuries caused by an accident that is attributed to the negligence of another person,” provided that the patient is admitted to the hospital within seventy-two hours of the accident. Tex. Prop.Code § 55.002(a). The lien also attaches to the proceeds of a settlement of the patient’s cause of action *538 or to damages awarded in a judgment. Id. § 55.003(a)(2)-(3). A hospital must comply with statutory notice and recording requirements to secure its lien. Id. § 55.005. The Hospital undisputedly complied with those requirements in this case.

Ideally, the statute serves its purpose: an accident victim receives necessary medical treatment, and the treating hospital is ensured at least partial payment, even when the patient is indigent. This case requires us to examine the consequences when, notwithstanding a valid lien and settlement proceeds to which the lien attaches, a hospital does not receive the payment contemplated by the statute.

A. Payment of Charges under Section 55.007

The applicability of section 55.007 of the Hospital Lien Statute forms the crux of the parties’ dispute. That section, which addresses the effect of a hospital lien on the validity of a release of the underlying cause of action to which the lien has attached, provides in pertinent part:

(a) A release of a cause of action ... to which a lien under this chapter may attach is not valid unless:
(1) the charges of the hospital or emergency medical services provider claiming the lien were paid in full before the execution and delivery of the release;
(2) the charges of the hospital or emergency medical services provider claiming the lien were paid before the execution and delivery of the release to the extent of any full and true consideration paid to the injured individual by or on behalf of the other parties to the release; or
(3) the hospital or emergency medical services provider claiming the lien is a party to the release.

Id. § 55.007(a). The satisfaction of one of the three options in section 55.007(a) is thus a condition to the validity of the release. In this case, it is undisputed that the Hospital’s charges for treating Gil and Hernandez were not and have not been paid in full, and that the Hospital was not a party to the releases of the patients’ causes of action against Benavidez. See id. § 55.007(a)(1), (3). The parties dispute only whether the Hospital’s charges were “paid ... to the extent of any full and true consideration paid to [Gil and Hernandez],” such that the releases were valid under section 55.007(a)(2).

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Bluebook (online)
433 S.W.3d 535, 57 Tex. Sup. Ct. J. 579, 83 U.C.C. Rep. Serv. 2d (West) 683, 2014 WL 1998245, 2014 Tex. LEXIS 394, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mcallen-hospitals-lp-dba-mcallen-medical-center-v-state-farm-county-tex-2014.