Detailed Answer — Can a doctor or facility treat me on a lien basis in Massachusetts?
Short answer: yes, many doctors and some facilities will agree to treat an injured person on a lien or assignment basis, but Massachusetts law does not automatically create a hospital or medical lien simply by providing treatment. In practice, a provider who agrees to defer billing until you resolve a personal injury claim typically relies on a written agreement that assigns the provider the right to be paid from any settlement or judgment you obtain. That agreement, and how it is enforced, affects who gets paid first from a recovery and how much you ultimately owe.
What “treat on lien” usually means
When a medical provider agrees to treat you “on a lien” (sometimes called a medical lien, treatment on lien, or an assignment of proceeds), it generally means:
- The provider agrees to give you necessary medical care now and delay collection.
- You sign a written document giving the provider the right to seek payment out of any personal injury settlement or court award you later obtain.
- The provider’s right to payment depends on your recovery; if you do not recover money from the at-fault party, the provider may not be paid (unless the agreement says otherwise).
How this works in Massachusetts
Massachusetts courts recognize assignments and equitable liens when parties agree that a provider will be paid from proceeds of a claim. However, these are contract- and equity-based remedies rather than an automatic statutory lien that springs into being just because treatment occurred. That means:
- Providers rely on a written agreement that clearly states how charges will be paid from any recovery.
- Your attorney, the provider, and the defendant/insurer will often negotiate how settlement proceeds are split (medical bills, attorney’s fees, your net recovery).
- Priority disputes can arise among providers, insurers (including health insurers or Medicare), and your lawyer; these are resolved under contract, federal subrogation rules (if Medicare/Medicaid is involved), and equitable principles.
Who will commonly treat on lien
Providers that often accept lien or assignment arrangements in personal injury matters include:
- Personal injury medical clinics and specialist groups (orthopedics, pain management).
- Chiropractors and physical therapists (many offer lien arrangements).
- Some urgent care centers and private physicians (varies widely).
- Hospitals—less commonly. Large hospitals may be unwilling to treat on lien without a guarantee; some hospitals offer financial assistance or payment plans instead.
How to find these providers in Massachusetts
- Contact a personal injury attorney immediately. Attorneys maintain referral networks of doctors and clinics that routinely treat on lien. An attorney can also advise on how a lien will affect your settlement and negotiate with providers and insurers.
- Ask local personal injury clinics or specialists. Search for “personal injury clinic,” “treat on lien,” or “medical lien” in your area. Call and ask whether they accept lien agreements and what their written lien form requires.
- Call billing or patient financial services at hospitals. Ask whether they will accept a deferred-payment arrangement, a lien, or if they offer financial assistance programs. Policies vary by hospital.
- Use attorney referral services and legal aid resources. The Massachusetts Bar Association and local legal aid groups can connect you with attorneys and clinics experienced in PI liens. See Massachusetts General Laws and consumer resources at: https://malegislature.gov/Laws/GeneralLaws and find lawyer resources at https://www.massbar.org/for-the-public
- Check whether your health insurer or Medicare applies. If you have private insurance, Medicare, or MassHealth, those payers may have subrogation or reimbursement rights and may require repayment from any settlement. Tell providers about your coverage so they can account for those rights in any lien or assignment.
What to ask before you sign a lien or assignment
- Will the provider accept reduced payment if your case settles for less than anticipated?
- Does the lien apply only to proceeds from this specific claim, or to other recoveries as well?
- Who will pay if you receive no recovery? (Some agreements leave you personally responsible.)
- How will the provider’s billed charges be calculated and documented?
- How will payments be prioritized among your attorney’s fees, medical liens, and other creditors?
- Will the provider deal directly with your attorney and the insurer to coordinate payments?
Practical steps to increase chances a provider will accept a lien
- Get a credible attorney referral. Providers work more readily with attorneys they know and trust.
- Provide clear information about the accident, any at-fault party, and insurer contact info.
- Be honest about your insurance and ability to pay if you do not recover money.
- Sign a clear, limited written assignment (not an overly broad document that creates disputes later).
Timelines and statute of limitations
Personal injury claims have strict deadlines. In Massachusetts, many personal injury actions must be filed within a limited time after the accident (be mindful of the statute of limitations). If you delay treatment or delay talking to an attorney, you could jeopardize your claim or your ability to secure treatment on lien. For general statutory text and deadlines, search Massachusetts General Laws: https://malegislature.gov/Laws/GeneralLaws
Potential complications
- Multiple providers can claim liens and create disputes over who is paid first.
- Health insurers (including Medicare/Medicaid) can assert subrogation or repayment rights and may reduce what ultimately remains for you.
- Some providers may refuse lien treatment or insist on partial up-front payment.
- Written lien language matters; vague agreements can lead to litigation.
Bottom line: You can often find doctors and clinics in Massachusetts willing to treat you on a lien or assignment basis, especially if you involve an experienced personal injury attorney early. Always get any lien or assignment in writing, disclose your insurance status, and understand how liens will affect settlement proceeds.
Disclaimer: This article explains general Massachusetts legal concepts and practical steps. It is not legal advice. For advice about your specific situation, consult a licensed Massachusetts attorney. For statutory language and official resources, see the Massachusetts General Laws: https://malegislature.gov/Laws/GeneralLaws
Helpful Hints — Finding and working with providers who treat on lien
- Start early: Contact an attorney and potential providers quickly to preserve your options.
- Get everything in writing: Require a signed, clear lien or assignment that states limits, fees, and what happens if you recover nothing.
- Ask about billing practices: Confirm whether billed charges will be reduced, and how payment will be split after attorney fees and expenses.
- Tell providers about other payers: Inform them of private insurance, Medicare, or MassHealth so they can address subrogation or repayment obligations.
- Use local resources: Ask the Massachusetts Bar Association or local personal injury attorneys for trusted provider referrals.
- Don’t assume hospitals will treat on lien: Larger hospitals often require guarantors or up-front arrangements; look for specialty PI clinics instead.
- Prepare documentation: Keep accident reports, medical records, and insurer contact information handy to give providers the evidence they may request.
- Understand your liabilities: Some lien agreements can leave you responsible if your case yields no recovery—know that risk before signing.