Under O.C.G.A. §§ 44-14-470 to -473, hospitals, nursing homes, physician practices, chiropractic practices, and certain burn care practices can claim a lien for reasonable charges against your injury claim, not against you or your property. The lien must be perfected by notice and a filing within 75 days of discharge (hospitals) or 90 days of first treatment (physician practices), and it's generally unenforceable unless the provider first billed your health insurance and was rejected.
A hospital lien is a provider's claim to be paid out of your injury settlement or verdict. It's common after emergency treatment, especially when the hospital knows a crash was involved. The lien doesn't mean you did anything wrong, and it doesn't put your home or wages at risk. But it does have to be dealt with before settlement money is paid out.
Who can file a lien
Under O.C.G.A. § 44-14-470(b), a lien can be claimed by those operating a hospital, nursing home, physician practice, or chiropractic practice, and by a traumatic burn care practice with charges over $50,000 from a single accident. The lien is for reasonable charges for care related to the injury.
What the lien attaches to
The statute is explicit: the lien "is only a lien against such causes of action and shall not be a lien against such injured person." It attaches to your claim against the person who caused the injury, and it's subject to any attorney's lien. The notice a provider sends must say the lien "is not a lien against the patient or any other property or assets of the patient."
How a lien is perfected: strict deadlines
- Notice: the provider must send written notice to the patient and to the parties believed liable and their insurers at least 15 days before filing, by first-class and certified mail or statutory overnight delivery (O.C.G.A. § 44-14-471(a)).
- Filing deadline for hospitals, nursing homes, and burn care practices: within 75 days after the patient is discharged.
- Filing deadline for physician and chiropractic practices: within 90 days after the patient first sought treatment.
- Where: the superior court clerk in the county where the provider is located, and in the patient's county of residence if a Georgia resident.
- Failing to comply on time "shall invalidate such lien," except against a liable party who had actual notice of the filed lien before settling (§ 44-14-471(b)).
The health insurance rule
This is one of the most useful protections for patients. Under O.C.G.A. § 44-14-471(c), the lien can't be enforced unless the provider first submitted the bill to the patient's health insurance (if any) and the claim was rejected. Some providers prefer to skip insurance and wait for a settlement, because they can collect their full charges instead of the insurer's negotiated rate. If you have health insurance, give it to every provider and ask them to bill it.
For injuries after April 21, 2025, the jury can also hear what your health insurance would pay for care. See how medical bills are proven in Georgia.
How liens are handled at settlement
- A release isn't effective against a properly filed lien unless the lienholder joins in it or releases the lien (O.C.G.A. § 44-14-473), with an exception for a settling party who gets the statutory affidavit that the bills have been paid.
- A provider must sue to enforce its lien within one year after liability is finally determined.
- In practice, your lawyer verifies whether each lien was properly perfected, checks the charges for errors and unrelated care, and negotiates. Valid liens are paid from the settlement before the client's share is disbursed, and they should appear on your closing statement. See how contingency fees work.
Medicaid has its own lien
If Georgia Medicaid paid your bills, the Department of Community Health has a separate lien under O.C.G.A. § 49-4-149, with a one-year filing period. Medicare and private health plans have their own repayment rights. See Medicare, Medicaid, and health insurance liens.
What to do if you get a lien notice
- Don't ignore it, and don't panic. Keep the notice and send a copy to your lawyer.
- Give the provider your health insurance information in writing and ask that the bill be submitted.
- Request an itemized bill.
- Don't settle with the at-fault insurer on your own while a lien is pending. A release that ignores a valid lien can create problems for everyone.
Frequently Asked Questions
Can a Georgia hospital put a lien on my house after a car accident?
No. Under O.C.G.A. § 44-14-470, a hospital lien is only against your claim against the person who caused the injury, not against you or your property.
How long does a hospital have to file a lien in Georgia?
Hospitals, nursing homes, and burn care practices must file within 75 days after discharge; physician and chiropractic practices within 90 days after the patient first sought treatment. Notice must be sent at least 15 days before filing.
Can the hospital refuse to bill my health insurance and file a lien instead?
The lien is unenforceable unless the provider first submitted the bill to your health insurance (if you have it) and the claim was rejected (O.C.G.A. § 44-14-471(c)).
Are hospital liens negotiable?
Often. Lawyers review liens for proper perfection, billing errors, unrelated charges, and reasonableness, and negotiate reductions where appropriate. Results vary by provider and case.
Sources
This guide is general information about Georgia law as of October 29, 2026. It is not legal advice, and reading it does not create an attorney-client relationship. Laws change and every case turns on its own facts. Talk to a lawyer about your situation before you rely on a deadline or rule described here.