Last Updated On: 16 January 2020

The Wall Street Journal: Doctors earn higher rates treating uninsured and underinsured patients on lien

More and more physicians across California have begun treating victims of personal injury incidents on lien, agreeing to be paid only after a lawsuit is decided. These “lien doctors” can provide excellent treatment options for those with limited or no health insurance. A recent article in The Wall Street Journal examines the growing popularity of this practice over the last decade, and how it has been a boon for accident victims unable to pay for care, and the doctors who treat them. 

“A 2011 decision in California’s highest court curtailed plaintiff payouts by creating a distinction between the sometimes low negotiated rates insurance pays and the higher amounts often charged by doctors,” the article reads. “The court found plaintiffs can recover the lesser of either the amount paid or incurred for medical services or the ‘reasonable market value’ of the care. With insurance, the court found, the ‘amount incurred’ is what insurance actually paid, even if a medical provider billed a higher amount.”

Although this decision was originally seen as a windfall for defense attorneys, the Howell decision, as it’s become known, has actually made sending plaintiffs to lien doctors a more promising option for their attorneys. Instead of restraining juries from considering insurance payouts for procedures, Howell allowed the full medical costs to be considered when lien doctors provide treatment. This could be a huge win for medical practices, as they’re sometimes able to negotiate rates that are much higher than they would otherwise receive from insurance providers.

Individuals seeking treatment on lien are prohibited from submitting related medical bills to their insurance provider, however, thus accepting responsibility for paying anything not covered by their settlement. While critics contend that lien doctors exploit patients with artificially inflated medical bills should their case fail, liens are often reduced through negotiation should a plaintiff’s attorneys fail to achieve the results they were seeking. Others argue that the higher rates some lien doctors charge are justified due to the relatively higher risk of nonpayment should litigation not go as expected, and the possible necessity for rate negotiation after the fact.

Despite these criticisms, however, lien doctors provide many accident victims with their best hope of receiving the care they need. 

Are you considering taking personal injury cases on lien, or are you looking for ways to improve your personal injury caseload? The Wall Street Journal mentions Power Liens as a prime conduit between lien doctors and law firms looking to enlist their services. Since 2012, Power Liens has been connecting attorneys with physicians on liens. We continue to grow, based on the strength of the relationships we’ve nurtured between law firms and medical practices throughout California.

Check out for our full directory of providers, or call us at 800-680-5526 for more information about how Power Liens can help bolster your personal injury practice!


The Wall Street Journal, “Who Wins in a Personal-Injury Lawsuit? It Can Be the Doctor,” Randazzo, Sara, January 8, 2020