Ariz. Rev. Stat. » Title 33

Ariz. Rev. Stat. § 33-931

Lien of health care provider on damages recovered by injured person receiving services; hospital priority; enforcement

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A. Every individual, partnership, firm, association, corporation or institution or any governmental unit that maintains and operates a health care institution or provides health care services in this state and that has been duly licensed by this state, or any political subdivision or private entity with ambulances operated, licensed or registered pursuant to title 36, chapter 21.1, is entitled to a lien for the care and treatment or transportation of an injured person as prescribed by subsection E of this section. The lien shall be for the claimant's customary charges for care and treatment or transportation of an injured person. A lien pursuant to this section extends to all claims of liability or indemnity, except health insurance and medical payments coverage and underinsured motorist and uninsured motorist coverage as defined in section 20-259.01, for damages accruing to the person to whom the services are rendered, or to that person's legal representative, on account of the injuries that gave rise to the claims and that required the services.

B. If a county maintains, operates or provides health care services, the county is entitled to an assignment by operation of law for the care and treatment or transportation of an injured person as prescribed by subsection E of this section.  The assignment shall be for the claimant's customary charges for care and treatment or transportation of an injured person.  An assignment pursuant to this section extends to any claims of liability or indemnity, except health insurance and medical payments coverage and underinsured motorist and uninsured motorist coverage as defined in section 20-259.01, for damages accruing to the person to whom the services are rendered, or to that person's legal representative, on account of injuries that gave rise to the claims and that required the services.

C. The lien entitlements authorized by subsection A of this section and the assignment authorized by subsection B of this section are applicable to all customary charges by hospitals or ambulances of political subdivisions, but are restricted to customary charges in excess of $250 by all other providers and privately owned ambulance companies excluding interest and service charges.

D. Liens perfected pursuant to this article by a hospital have priority for payment over all other liens authorized by this article.

E. The liens and assignments authorized by this section are enforceable by a cause of action prescribed by section 33-934 and are subject to the following:

1. One-third of any third-party judgment, settlement or award is exempt from any lien or assignment authorized by this section.

2. If the injured person is covered as an insured or dependent under a health insurance or similar medical benefit plan and the health care provider has a valid and binding contract with that insurer or plan as an in-network provider, the contract must expressly allow the health care provider to assert a lien or assignment that is authorized by this section. In the absence of that contract provision, the lien or assignment is invalid and may not be enforced by a cause of action prescribed by section 33-934 except as allowed under paragraph 3 or 4 of this subsection.

3. Paragraphs 1 and 2 of this subsection do not apply if any of the following exceptions are met:

(a) The services provided are not covered by the injured person's health insurance or similar medical benefit plan.

(b) The health care provider does not have a valid and binding contract with the insurer or plan as an in-network provider.

(c) The injured person is not covered by any health insurance or any similar medical benefit plan.

(d) The injured person and the health care provider have a written and signed document stating that they elect not to use any coverage potentially available under a health insurance or similar medical benefit plan that covers the injured as an insured or dependent.

4. Notwithstanding paragraphs 1, 2, and 3 of this subsection, a health care provider may enforce a lien or assignment authorized by this section by a cause of action prescribed by section 33-934 for all amounts for which a patient is personally responsible, including outstanding coinsurance amounts, copayments and deductibles that are due under the injured person's or dependent's health insurance or similar medical benefit plan.

5. Any valid and enforceable lien or assignment authorized by this section shall be compromised pursuant to the criteria prescribed by section 33-937.

6. Any valid and enforceable lien or assignment authorized by this section shall be subordinate to any lien with higher priority.

F. This section does not affect the rights of a health care provider to enforce a consensual agreement, whether called a lien or contract, against the patient who has signed the agreement.

Notes of Decisions
Cited in 31 cases (3 in the last 5 years), 1973–2023 · leading case: Andrews v. Samaritan Health System
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Andrews v. Samaritan Health System (2001) arizctapp · cites it 37× “See A.R.S. § 33-931. The parties filed cross motions for summary judgment.”
Blankenbaker v. Jonovich (2003) ariz · cites it 18× “Blankenbaker had not complied with the perfection provisions of the health care provider lien statutes, A.R.S. §§ 33-931 to -936 (2000). Lacking jurisdiction to issue declaratory judgments, the justice court transferred the action to superior court.”
Jackie Abbott v. Banner Health Network (2016) ariz · cites it 12× “The Hospitals then recorded liens against the Patients pursuant to AR.S. § 33-931 and AR.S. § 36-2903.01(G) for the difference between the amount typically charged for their treatment and the reduced amount paid by AHCCCS.”
Premier Physicians Group, PLLC v. Navarro (2016) ariz · cites it 6× “Before 1988, such liens were available only to hospitals; that year, they were extended to non-hospital health care providers through A.R.S. §§ 33-931, -932. 1988 Ariz. Sess. Laws, ch.”
Maricopa County v. Barfield (2003) arizctapp · cites it 18× “Rather, “ § 33-934 expressly delineates the parties against whom an enforcement action may be brought: ‘the claimant or assignee of the hen or assignment may enforce the hen or assignment by action against the person, firm, or corporation liable for damages.”
Samsel v. Allstate Insurance (2002) ariz · cites it 8× “The insured's property interest in his or her tort claim and eventual recovery is affected when and if the debt is eventually satisfied from the insured's property.”
Walter Ansley v. Banner Health Network (2020) ariz · cites it 6× “We hold that the patients have a private right of action, and that A.R.S. §§ 33-931(A) and 36-2903.01(G)(4) are preempted to the extent hospitals utilize them against third-party tortfeasors for “balance billing” to recover costs exceeding Medicaid reimbursement.”
Gartin v. St. Joseph's Hospital & Medical Center (1988) arizctapp · cites it 12× “Joseph’s recorded its statutory hospital lien pursuant to A.R.S. § 33-931, et seq. 6. Plaintiffs herein filed suit against the Kohls in Maricopa County Superior Court for the wrongful death of Gartin, including allegations that the Kohls were negligent in causing Gartin’s death.”
LaBombard v. Samaritan Health System (1998) arizctapp · cites it 6× “Every individual, partnership, firm, association, corporation or institution or any governmental unit maintaining and operating or providing health care services in this state, which has been duly licensed by this state or any political subdivision or private entity with…”
Ansley v. Banner Health (2019) arizctapp · cites it 15× “A hospital may collect any unpaid portion of its bill from other third-party payors or in situations covered by [A.R.S. § 33-931]. A.R.S. § 36-2903.01(G)(4).”
Dignity Health v. Farmers Ins. Co. of Ariz. (2019) arizctapp · cites it 33× “DISCUSSION ¶4 Under A.R.S. § 33-931, a health care provider may obtain a lien to secure payment of customary charges for services provided to an injured person, with certain express exceptions to the scope of such a lien: A lien pursuant to this section extends to all claims of…”
Hobson v. Mid-Century Insurance (2001) arizctapp · cites it 3× “Unlike § 23-1023(0, the hospital lien statute at issue in LaBombard , A.R.S. § 33-931, did not provide for a deduction of attorney’s fees and costs “off the top” in computing the lien.”
Show all 31 citing cases →
— Ariz. Rev. Stat. § 33-931(A) — 18 cases
Walter Ansley v. Banner Health Network (2020) ariz “We hold that the patients have a private right of action, and that A.R.S. §§ 33-931(A) and 36-2903.01(G)(4) are preempted to the extent hospitals utilize them against third-party tortfeasors for “balance billing” to recover costs exceeding Medicaid reimbursement.”
Blankenbaker v. Jonovich (2003) ariz “Blankenbaker had not complied with the perfection provisions of the health care provider lien statutes, A.R.S. §§ 33-931 to -936 (2000). Lacking jurisdiction to issue declaratory judgments, the justice court transferred the action to superior court.”
Premier Physicians Group, PLLC v. Navarro (2016) ariz “Before 1988, such liens were available only to hospitals; that year, they were extended to non-hospital health care providers through A.R.S. §§ 33-931, -932. 1988 Ariz. Sess. Laws, ch.”
Jackie Abbott v. Banner Health Network (2016) ariz “The Hospitals then recorded liens against the Patients pursuant to AR.S. § 33-931 and AR.S. § 36-2903.01(G) for the difference between the amount typically charged for their treatment and the reduced amount paid by AHCCCS.”
Andrews v. Samaritan Health System (2001) arizctapp “See A.R.S. § 33-931. The parties filed cross motions for summary judgment.”
— Ariz. Rev. Stat. § 33-931(B) — 2 cases
LaBombard v. Samaritan Health System (1998) arizctapp “Every individual, partnership, firm, association, corporation or institution or any governmental unit maintaining and operating or providing health care services in this state, which has been duly licensed by this state or any political subdivision or private entity with…”
Maricopa County v. Barfield (2003) arizctapp “Rather, “ § 33-934 expressly delineates the parties against whom an enforcement action may be brought: ‘the claimant or assignee of the hen or assignment may enforce the hen or assignment by action against the person, firm, or corporation liable for damages.”
— Ariz. Rev. Stat. § 33-931(C) — 5 cases
Andrews v. Samaritan Health System (2001) arizctapp “See A.R.S. § 33-931. The parties filed cross motions for summary judgment.”
Abbott v. Banner Health Network (2014) arizctapp
Jackie Abbott v. Banner Health Network (2016) ariz
Grunwald v. Scottsdale Healthcare (2021) arizctapp
Cvs Pharmacy v. Hon. bostwick/tucson Medical (2021) ariz
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