In the midst of a health crisis in America, now is a great time to make sure that if crisis strikes, you can talk to your loved one’s medical team.

Now is a a GREAT time to do a living will (declaration for a natural death) and a health care power of attorney. Parents of 18 year olds- even if they act like kids, they are not in the eyes of the law. If your college freshman gets sick, you need a HIPAA release (at the very least) to get information.

So get some health care power of attorneys, HIPAA Forms, and other documents you need. The NC Secretary of State, Elaine Marshall, has most of the forms for free! They do not have to be formally registered, but you can register them with the Secretary of State for $10 for extra protection. Hospitals can check the registry. The forms do need to be notarized. Check with your bank about notarizing things. During Covid you can do some notary functions by video!

Here is a link to those NC Secretary of State free downloadable forms: https://www.sosnc.gov/divisions/advance_healthcare_directives?fbclid=IwAR0Gs6izQzGZ4mxaTcBVXUs8CqIJg5gCH-7cTejvUiqGPo3Pk5gbuOPPvZ4

A plain old HIPAA (medical release) form will allow doctors to talk and most hospitals won’t require it to be notarized.

Here is a generic HIPAA you can use that is “form fillable” as a PDF or printable. If you have a printer, I would actually print it out and fill it in by hand rather than use the electronic signature. But if you don’t have access to a printer, this should work too.

I’ve always found that the more I prepare for trial, the less likely I am to have a trial. So think of this as the lowest risk preventative medicine ever!

Note: these forms can be little complicated, so if you have questions, look for an estate planning lawyer near you. I don’t do that type of work, so I’m not your go-to person to answer specifics. 🙂

Chris Nichols, Attorney
Nichols Law Firm
From the home office

Can a medical provider claim a lien under NCGS 44-49 if the medical bills have been paid by the workers compensation carrier prior to injured worker pursuing a third part claim against a tortfeasor?

Worker was injured, workers comp. paid his medical bills at the local hospital. A case was pursued against the negligent third party and we just received a lien notification letter from the hospital.

Can they do this?

My answer:

No. A workers compensation (WC) medical payment is a “payment in full.” The hospital submitted to WC, WC paid what is the allowable expense and the hospital has to write off the remainder. They don’t get to double bill or bill for the unpaid portion.

I would write the hospital a letter asking them to set out in writing what what the total charges are, what they have been paid in the past, and what they are asking from your client now.

Get that in writing.

The follow up with a letter to the department that claimed the lien and make sure you copy one of the Medical Dcotors in charge with the following laws:

http://www.ncga.state.nc.us/EnactedLegislation/Statutes/HTML/BySection/Chapter_97/GS_97-26.html

A medical provider’s reimbursement is limited to the maximum amount approved in the NCIC Medical Fee Schedule, unless the provider has contracted with the insurer for a different amount. If neither the fee schedule nor a contractual fee applies, the maximum reimbursement allowed is the usual, customary, and reasonable charge for the service.

N.C.G.S. §97‐26(c)

N.C.G.S. §97‐90(e) governs this issue and states:

“A health care provider shall not pursue a private claim against an employee for all or part of the costs of medical treatment provided to the employee by the provider unless the employee’s claim or the treatment is finally adjudicated not to be compensable or the employee fails to request a hearing after denial of liability by the employer.”

N.C.G.S. §97‐88.3(c) establishes penalties for medical providers who improperly pursue private claims against employees:

“A health care provider who knowingly charges or otherwise holds an employee financially responsible for the cost of any services provided for a compensable injury under this Article is guilty of a Class 1 misdemeanor.”

That’s straight out of the North Carolina Medical Society guide: http://www.ncmedsoc.org/non_members/project_sustain/workerscomp_faq.pdf

I’m thinking that when faced with criminal liability, the hospital will about face on this one.

And of course, if the bill was never submitted to or paid by WC, then I think they can claim a lien. Though if they breached their duty to submit to WC, then they may just be completely out of luck.

Don’t forget that WC does have a lien for the medical bills they paid.

Chris Nichols
www.NicholsTrialLaw.com

As these things go, we lawyers know that the best way to get to the bottom of things is to “follow the money” and that’s what this post is all about.

And of course, what I’m talking about is the very recent creation of a “grass roots” effort to change the the laws of medical malpractice in North Carolina. That “grass roots” organization stealthily sprung to life on March 10, 2011, as a non-profit organization called “North Carolinians for Affordable Health Care, Inc.”

What follows is the story of the “birth of an astro-turf” organization. And if you are not familiar with that term, let me give you my definition. We’ve all heard of “grass roots” organizations, right? They start out with regular people who have a concern about something. Those people organize and get the word out and suddenly they create a movement which gains momentum. And when that movement gets big enough, these regular people get a “voice” on the public stage with the politicians and large corporations that can simply “buy” access to government with lobbyists. Well, “astro-turf” is the opposite of that. An “astro-turf” organization is something created by a corporation or a lobbyist to appear to be “of the people” when it is, in fact, just a shill by “the man”- some corporate interest that wants to pose as “the people.”

As you read this rather lengthy post, you’ll get to see how a small group of politically connected lawyers created an “astro-turf” organization to persuade politicians and the public to take away the rights or regular people to bring a claim against an insurance company and hospital when that hospital makes a mistake that injures, maims, or kills someone they love.

3/10/2011 Articles of incorporation for North Carolinians for Affordable Health Care (NCFAHC) is filed.

It is, of course, a Section 501(c)(4) Corporation.

The name and address of the incorporator is R. Donavon Munford, Jr.,

P. O. Box 2611, Raleigh, NC 27602-2611.

Reference: NC Secretary of State Filings

North Carolinians for Affordable Health Care is incorporated by a Republican former member of the NC General Assembly who is a partner in the Smith Anderson Law Firm

R. Donovan “Don” Munford was a Republican member of the North Carolina General Assembly representing the state’s thirty-fourth House district, including constituents in Wake County from 2002. Munford is a lawyer and accountant from Raleigh, North Carolina.

Munford ran for re-election to the North Carolina House of Representatives in the 2004 General Assembly election. He defeated J.H. Ross in the Republican primary, but lost to Democrat Grier Martin in the November 2004 general election.

 He is a partner at Smith Anderson, the largest law firm in the Raleigh area. He practices in the areas of corporate and business law, estate planning and asset protection planning. Munford is also a licensed Certified Public Accountant. (Reference: Munford Wikipedia Entry)

Smith Anderson Law Firm is a leading Medical Malpractice Insurance Defense law firm and also a government lobbying law firm.

Smith Anderson Law Firm registered the website for NCFAHC.

Reference: WhoIS Registration link

Smith Anderson Law Firm has a longstanding relationship with the North Carolina Medical Society and lobbies for them before the General Assembly.

The North Carolina Medical Society is lobbying for immunity from negligence for Emergency Rooms in NC.

3/16/2011 NCFAHC releases a commercial falsely alleging that North Carolina is experiencing “frivolous lawsuits” which increase taxes and insurance costs.

Follow the Money

Are “North Carolinians” demanding immunity for negligent Emergency Rooms and physicians, or is a small group of lawyers, lobbyists, and physicians looking to walk away from their responsibility to the injured, maimed, and killed?

Can anyone explain how making Emergency Rooms immune from claims or lawsuits for “negligence” furthers the Medical Society’s stated purpose to”raise the standards for their profession” and “protect the quality of patient care?”

North Carolina Senate Bill 33 (SB33) does exactly the opposite. SB 33 changes the rules for any medical person in the Emergency Room and eliminates responsibility for “negligence”. This does not “raise the standard” for the profession, but in fact drastically lowers the standard. 

So how does this “protect the quality of patient care?” Well, what happens when you say “you can no longer be held financially accountable for the consequences of sloppy work, negligent work, or breaking and ignoring the established rules in all other Emergency Rooms in the state of North Carolina?”

Does taking accountability away from Doctors, Nurses and Hospitals somehow make people more responsible? Or does it make them act “less responsible?”

How about this? What would happen if we eliminated all speed limits in North Carolina, and just told people not to drive “grossly fast”? Would our roads be safer, or less safe?

Bottom line, the NC Medical Society, through their lawyers and lobbyists are “posing” as you, the people, in an effort to take away your right to hold a small group of bad doctors accountable.

And of course, where do the ACTUAL people stand on this issue?

Please write your elected House member a note and tell them to oppose this Bill.

Here is how to look them up: Who Represents Me?

(Scroll down to the bottom and look up by your Zip code)

This proposed Senate Bill S33 is a laundry list of of ways to limit the rights of normal citizens in NC. While physicians may THINK this proposed Bill will help them, in reality, the bill is a giant GIFT to the insurance industry because it simply reduces the amounts of money insurance companies might have to pay in legitimate claims. Or put another way, it limits the recovery of individuals whom a jury have determined are truly injured by medical negligence.

Here is a quick rundown on the Bill and my comments on the reality of the provisions.

EMERGENCY MEDICAL CARE- If your emergency room doctor commits negligence, you can’t sue them. You can only sue if they are GROSSLY negligent, like, if they were drunk. So, when the ER doc gives your spouse an injection of penicillin, even though her medical chart says she is severely allergic to it, and she dies- too bad. Gross negligence is a very high standard in North Carolina.

BIFURCATION OF TRIALS ON ISSUES OF LIABILITY AND DAMAGES in any case over $75,000.

This means that in any case with a value of over $75,000 (which is almost every medical malpractice case out there) you essentially have two trials. The first part is on the question of negligence. Did the doctor make a mistake. The second part is on the damages. Sounds tempting and simple but the real reason behind this is two fold. First, it makes trials longer and more costly for the injured party. Many witnesses who could testify once, now have to testify twice. Experts are very expensive, sometimes $5,000 per day. Insurance Companies have nearly unlimited resources to bring in experts. Injured people do not. Second, by keeping out the damages, the jury does not have any idea how badly the mistake has affected the injured person. This “depersonalizes” the case which is an advantage to the Defendant.

LIMITING THE AMOUNT OF NONECONOMIC DAMAGES THAT MAY BE AWARDED ($250,000 cap on damages) As used in this section, ‘noneconomic damages’ means damages to compensate for pain, suffering, emotional distress, loss of consortium, inconvenience, physical impairment, disfigurement, and any other nonpecuniary, compensatory damage. So if your child is burned on 90% of their body in a negligent surgical fire, they get about $3,000 a year for life. And of course, this cap on damages ONLY affects people who have a legitimate case, i.e., some one whom a jury has just determined is injured as a result of negligence. This cap also disproportionately effects retired people who do not have future lost earnings. And of course, this means insurance companies can get off cheap, even if a jury thinks a higher amount is warranted.

BY AUTHORIZING THE PERIODIC PAYMENT OF FUTURE ECONOMIC DAMAGES IN LIEU OF A LUMP-SUM PAYMENT. Basically, this is in there because if the person who is awarded damages by a jury dies later, their family will not inherit the money. It will go back to the insurance company.

MODIFYING APPEAL BONDS IN MEDICAL MALPRACTICE ACTIONS. This just makes it cheaper for insurance companies to appeal when they lose.

If approved, this act becomes effective October 1, 2011. (Better go to the doctor now.)

When “tort reform” was being debated on the Federal level, I produced a mock “Do It Yourself Tort Reform Release” which tried to demonstrate the reality of what the law makers were proposing. It got picked up by some national press and “went viral,” in as much as something about the law goes viral.

So, if you just can’t wait for Medical Malpractice “tort reform”, just download this handy form, sign it, and take it to your next doctor’s appointment.