Council rejects ordinance granting hospitals prioritized lien rights on settlements

The Volusia County Council on Tuesday declined to approve an ordinance that would have established prioritized medical-provider lien rights for certain nonprofit hospitals and county emergency medical services in settlement proceeds from injury cases.

The proposed ordinance (Ordinance 2025-9) would have granted lien rights for specified charitable hospitals and county EMS for outstanding reasonable charges for medical care, with specific language about reimbursement amounts tied to insurance reimbursements or, for uninsured patients, to the hospital's reasonable outstanding charges. After public testimony and deliberation the council voted against the ordinance by a 4-3 margin.

Why the debate intensified

The measure drew sustained public comment. Halifax Health's deputy general counsel, Jillian Wheelock, told the council the hospital system sought the ordinance to recoup uncompensated care and to protect the county's taxpayers from higher costs for indigent care. "It would benefit the taxpayer and the constituents of this county in several ways," Wheelock said, arguing lien rights would help reduce the county subsidy required for uncompensated care.

Doctors and small medical providers urged the council to oppose the ordinance, saying it would create an unfair priority for large hospitals and impair access to post-hospital care for uninsured or underinsured patients. Dr. Leonard Roman, a local chiropractic physician, told the council "The ordinance is nothing more than that type of entitlement," arguing it would disadvantage medical providers who commonly accept letters of protection and delayed payment methods to treat injured patients.

Public comments also emphasized existing legal complexity. Several plaintiffs'side attorneys and doctors noted recent changes in state law (tort reform signed in 2023) that have altered letters-of-protection practices and warned the county ordinance could increase litigation about who is owed settlement proceeds.

Council consideration and vote

Motion: Approve Ordinance 2025-9 (add Chapter 58, Article 5: medical provider liens). Mover: Councilman Jake Johansen. Second: Vice Chair Matt Reinhardt. Outcome: Motion failed, 4-3 (did not pass).

What it would have done

The ordinance would have given priority lien rights to nonprofit hospitals and county EMS when settlement proceeds are distributed, with limits stated in the ordinance about "reasonable" charges and, where insurance existed, limiting claims to the insurer's reimbursement amount for covered services. Supporters said hospitals are often first responders and frontline providers in crashes and should have a path to reimbursement; opponents warned the change would reduce the funds available to compensate later-stage care providers such as chiropractors, physical therapists and small imaging centers.

Why readers should care

The change would have affected how settlement money is divided after automobile crashes and other injury cases, potentially shifting more of the available funds to hospitals and EMS and away from later-stage care providers. Several local physicians argued that would reduce access to physical and rehabilitative care for uninsured or underinsured patients.

Ending: With the ordinance defeated, the county retains the existing settlement-priority practices. Council members and staff noted the complexity of the issue and encouraged further study and outreach; the subject may return in later form if the council or stakeholders pursue alternate approaches.