Ark. Code Ann. § 18-46-101 Title.
This chapter may be cited as the Medical, Nursing, Hospital, and Ambulance Service Lien Act.
Medical, Nursing, Hospital, and Ambulance Service Lien Act
Ark. Code Ann. tit. 18, ch. 46
in effectArk. Code Ann. § 18-46-102 Definitions.
As used in this chapter:
(1) “Ambulance service provider” means a provider that renders services as defined in § 14-266-103(1) and (2);
(2) “Claim” means the claim of a patient:
(A) For damages from a tortfeasor; or
(B) For benefits from an insurer;
(3) “Hospital” means a person that maintains an establishment in which sick and injured persons are given medical and surgical care;
(4) “Injury” means impairment of bodily, nervous, or mental integrity or health;
(5) “Insurer” means a person that by a contract of insurance has undertaken to indemnify a patient against loss through injury resulting from accident or accidental means;
(6) “Patient” means a person injured through the fault or neglect of another person, for the relief or cure of whose injury a practitioner, nurse, or hospital renders service;
(7) “Person” means a natural person, a partnership, an association, or a corporation;
(8) “Practitioner” means a person licensed to:
(A) Treat human ailments under the provisions of § 17-95-202 et seq.;
(B) Practice dentistry as defined in § 17-82-102;
(C) Practice chiropractic under the provisions of the Arkansas Chiropractic Practices Act, § 17-81-101 et seq.;
(D) Practice massage therapy under the Massage Therapy Act, § 17-86-101 et seq.; and
(E) Practice physical therapy under the Arkansas Physical Therapy Act, § 17-93-101 et seq.;
(9) “Service” means personal service, food, lodging, ambulance service, medical supplies and appliances, and whatever else is reasonably necessary for the care, treatment, and maintenance of a patient; and
(10) “Tortfeasor” means a person through whose fault or neglect a person is injured.
Ark. Code Ann. § 18-46-103 Attorney's liens not affected.
The liens given in this chapter shall in no way repeal or affect the statutory liens now provided in favor of attorneys.
Ark. Code Ann. § 18-46-104 Extent of lien.
On compliance with the requirements of this chapter, a practitioner, a nurse, an orthotist, a prosthetist, a pedorthist, a hospital, and an ambulance service provider shall each have a lien:
(1) For the value of the service rendered and to be rendered by the practitioner, nurse, orthotist, prosthetist, pedorthist, hospital, or ambulance service provider to a patient, at the express or implied request of the patient or of someone acting on his or her behalf, for the relief and cure of an injury suffered through the fault or neglect of someone other than the patient ;
(2) On any claim, right of action, and money to which the patient is entitled because of that injury, and to costs and attorney's fees incurred in enforcing that lien; and
(3) For the cost of a prosthesis, orthotic, pedorthic device, or medical appliance provided to the patient.
Ark. Code Ann. § 18-46-105 Notice required — Contents — Service — Amendments and supplements.
In order to establish a lien under this chapter, a practitioner, nurse, hospital, or ambulance service provider shall comply with the following conditions:
(1) Notice Required.
(A) The practitioner, nurse, hospital, or ambulance service provider shall serve on the patient a written notice of his or her claim of lien and shall serve a copy of that notice on the tortfeasor or on the insurer, if there is any, or, at the discretion of the practitioner, nurse, hospital, or ambulance service provider, or both. He or she shall file a copy of the notice so served in the office of the clerk of the circuit court in the county in which his or her professional, nursing, hospital, or ambulance service has been, or is being, rendered. The notice shall be authenticated by an affidavit to show that the notice and copies of it have been served as required by this chapter. This notice may be served and recorded at any time while service is being rendered and at any time after the discontinuance of service so long as the claim of the practitioner, nurse, hospital, or ambulance service provider for compensation for service is not barred by the statute of limitations.
(B) If, to the knowledge of the practitioner, nurse, hospital, or ambulance service provider, the patient against whose claim or right of action it is desired to establish a lien has instituted an action in any court in Arkansas to enforce his or her claim against the tortfeasor responsible for his or her injury, or against any insurer by which he or she was insured against loss through injury due to accident or accidental means, then the practitioner, nurse, hospital, or ambulance service provider may, in his or her or its discretion, in lieu of, or in addition to serving notice of his or her claim and recording the notice, as authorized by subdivision (1)(A) of this section, file a notice of his or her claim, duly authenticated under oath, in the court in which the action is pending. The filing of the notice of the claim shall be notice thereof to all parties to the action, without the serving of further notice of the recording of the copy of any notice in the office of the clerk of the circuit court.
(2) Contents of Notice.
(A) The notice required by this section shall show, so far as is known to the practitioner, nurse, hospital, or ambulance service provider on whose behalf it is filed or served:
(i) The name and address of the tortfeasor and, if a lien is claimed against an insurer, then the name and address of that insurer;
(ii) The name of the patient, his or her usual address, and his or her whereabouts when the notice is served, if elsewhere than at his or her usual address;
(iii) The name and address of the person claiming the lien, and whether he or she claims as a practitioner, nurse, hospital, or ambulance service provider;
(iv) The time when, place where, and circumstances under which the alleged fault or neglect of the tortfeasor occurred and the nature of the injury; and
(v) If the service of the practitioner, nurse, hospital, or ambulance service provider has been completed, the amount for which his or her lien is claimed.
(B) The notice shall be supported by an affidavit by the practitioner, nurse, hospital, or ambulance service provider showing that the facts stated of affiant's own knowledge are true, and that the facts stated on information and belief he or she believes to be true.
(C) If the professional, nursing, hospital, or ambulance service on which the claim of lien is based has not been completed when notice of the claim of lien is served and the amount for which a lien is claimed is not stated in the notice, then the practitioner, nurse, hospital, or ambulance service provider on whose behalf the notice has been served shall serve, within sixty (60) days after the termination of service, a supplementary notice on each person previously notified and file a notice in the court in which the previous notice was filed, showing the amount claimed under the lien.
(3) Method of Service of Notice. Any notice required by this chapter to be served shall be deemed to have been served:
(A) If delivered to the person on whom it is to be served or left at his or her usual place of business or residence with some person of mature years employed or dwelling there; or
(B) If delivered by registered mail at the last known address of the person to be notified, either within or without the State of Arkansas, as shown by the receipt returned by the United States Postal Service and by an affidavit by an affiant having personal knowledge of the facts, showing that the notice required by this section to be served was enclosed in the letter for which the receipt was returned, when that letter was deposited in the mail.
(4) Amendatory and Supplementary Notices. The fact that a practitioner, nurse, hospital, or ambulance service provider has filed a notice of the lien as authorized by this chapter shall not prevent his or her filing amendatory or supplementary notices of liens subsequently, but every amendatory and supplementary notice shall be served and filed in the same manner as the original notice.
Ark. Code Ann. § 18-46-106 Liens void after certain day unless action commenced.
(a) If at the expiration of one hundred eighty (180) days immediately following the day on which the most recent notice, amendatory notice, or supplementary notice of a claim of lien was filed in the office of the clerk of the circuit court, as authorized by this chapter, and if, in any event, immediately on the expiration of the period during which the practitioner, nurse, hospital, or ambulance service provider can enter action to enforce his or her or its claim against the patient for compensation for service rendered, the lien remains unsatisfied and unreleased, and no suit by the practitioner, nurse, hospital, or ambulance service provider by which notice of the lien was filed to enforce that lien is pending in any court, then the lien shall be void and of no effect.
(b)(1) Any patient against whose claim or right of action any void lien exists may enforce that claim or right of action discharged from that lien, on delivering to the tortfeasor or insurer an affidavit showing that no action is pending against the affiant to enforce the lien claimed by the practitioner, nurse, hospital, or ambulance service provider.
(2) On filing a copy of that affidavit with the clerk of the circuit court in whose office notice of the lien was originally filed, the clerk shall enter on his or her docket and file a notation to show that the lien has lapsed and is void.
(c) If the amount claimed under any lien has been paid into court, as authorized by this chapter, remains in the custody of the court after the lien has become void, on application by the tortfeasor or the insurer by which the money was so paid, supported by a copy of the record of the circuit court showing that the lien has lapsed, then the court may return the money to the person by whom it was deposited and give him or her judgment against the lienor for interest on the money during the time it was on deposit and for costs and a reasonable counsel fee.
(d) Any person who, in order to obtain the release of an alleged lapsed lien, makes a false affidavit and delivers a copy of it to any tortfeasor or insurer or files a copy of any such affidavit in the office of the clerk of the circuit court shall be guilty of perjury and subject to the penalties prescribed for that offense.
(e) If at the expiration of the one hundred eighty (180) days stated in subsection (a) of this section an action is pending by the practitioner, nurse, hospital, or ambulance service provider to enforce a claim of lien filed by him or her, the lien shall continue in full force and effect during the pendency of that suit, unless released by the practitioner, nurse, hospital, or ambulance service provider by whom the claim was filed.
Ark. Code Ann. § 18-46-107 Enforcement of perfected liens — Parties.
(a)(1) A practitioner, nurse, hospital, or ambulance service provider that has perfected a lien under the provisions of this chapter to secure the payment of a debt for service rendered may enforce that lien by any proper action against the patient, the tortfeasor, and the insurer, jointly or severally, in any court of competent jurisdiction.
(2) However, no such action shall be begun after action on the debt itself is barred by the statute of limitations.
(b)(1) The plaintiff in any such case shall make any and all persons having interests in the subject matter of the action, of whose interest he or she has knowledge, parties defendant. Any person having an interest in the subject matter of the action who is not made a party to it may, with the consent of the court, become a party in order to protect his or her interest.
(2) Persons having an interest in the subject matter of the action include, within the meaning of this section, all persons authorized by this chapter to establish liens to secure their interests, those whose claims against the patients are not, as well as those whose claims against the patients are, due at the time of the commencement of the action.
(c) Any two (2) or more persons having liens on the same claim or right of action of any patient may join in bringing action setting forth their respective rights in their pleading.
(d) An action to which any practitioner, nurse, hospital, or ambulance service provider having a lien on the subject matter is a party shall not be dismissed without his or her consent.
Ark. Code Ann. § 18-46-108 Liens assignable — Enforcement.
(a) All liens or claims of liens that accrue to any practitioner, nurse, hospital, or ambulance service providers under this chapter are assignable.
(b) Proceedings to enforce assigned liens or claims of liens may be maintained by, and in the name of, the assignee. The assignee shall have as full and complete power to enforce the lien or claim of lien assigned to him or her as if proceedings to that end were taken under this chapter by and in the name of the assignor.
Ark. Code Ann. § 18-46-109 Subrogation of rights.
Any person who, with the consent of a patient injured through the fault or neglect of another person, pays to a practitioner, nurse, hospital, or ambulance service provider the amount due for service to that patient shall be subrogated to the rights of the payee with respect to the establishment and enforcement of a lien under this chapter.
Ark. Code Ann. § 18-46-110 Persons under legal disability.
If any person, because of minority, mental defect, death, or other legal disability, cannot exercise any right conferred on him or her by this chapter or discharge any duty imposed on him or her by it, that right may be exercised and that duty shall be discharged, by his or her father, mother, guardian, executor, or administrator, as the circumstances of the case require.
Ark. Code Ann. § 18-46-111 Incorporation of lien in action by patient.
If a patient has instituted an action in any court in Arkansas to enforce his or her claim against the tortfeasor through whose fault or neglect he or she was injured, or against any insurer by which he or she was insured against loss through accident or accidental means, and a practitioner, nurse, hospital, or ambulance service provider has filed in the court in which the action is pending a notice of his or her claim of lien, as authorized by this chapter, the court before which the action is pending shall have jurisdiction with respect to that claim of lien and shall embody in its judgment such an award with respect thereto as the evidence warrants.
Ark. Code Ann. § 18-46-112 Settlement of patient's claim without satisfaction of lien prohibited.
(a) A tortfeasor and an insurer, and each of them, who have been notified, as authorized by this chapter, of a claim of lien against any claim or right of action that a patient has against the tortfeasor or insurer by reason of an injury caused by the fault or neglect of a tortfeasor shall not, within sixty (60) days after the service of the notice, nor at any time after a copy of that notice has been recorded in the office of the clerk of the circuit court of the county in which the professional, nursing, hospital, or ambulance service was rendered, pay to the patient, either directly or indirectly, any money or deliver to him or her, either directly or indirectly, anything of value, in settlement or part settlement of the patient's claim or right of action, without having previously:
(1) Paid to the practitioner, nurse, hospital, or ambulance service provider that gave notice of the claim of lien the amount claimed under it; or
(2) Received a written release of the claim of lien from the practitioner, nurse, hospital, or ambulance service provider that gave notice of it, except as otherwise authorized by this chapter.
(b) A tortfeasor and an insurer, and either of them, that have been notified by a practitioner, nurse, hospital, or ambulance service provider of claim of lien under this chapter and who, directly or indirectly, otherwise than as is authorized by this chapter, pays to the patient any money or delivers to him or her anything of value as a settlement or compromise of the patient's claim arising out of the injury done to him or her shall be liable to the practitioner, nurse, hospital, or ambulance service provider for the money value of the service rendered by the practitioner, nurse, hospital, or ambulance service provider, in an amount not in excess of the amount to which the patient was entitled from the tortfeasor or insurer because of the injury.
Ark. Code Ann. § 18-46-113 Waiver or release of claim by patient.
(a) A patient who has been notified by a practitioner, nurse, hospital, or ambulance service provider of a claim of lien on any claim or right of action that the patient has because of the injury for which service was rendered shall not waive or release that claim, or any part of it, unless:
(1) The amount claimed by the practitioner, nurse, hospital, or ambulance service provider, under the lien, has been paid; or
(2) The practitioner, nurse, hospital, or ambulance service provider has in writing released his or her lien.
(b) Any waiver or release given contrary to the provisions of this chapter shall be void and of no effect.
Ark. Code Ann. § 18-46-114 Release on satisfaction or waiver of lien required.
(a) If a lien has been satisfied or waived, the practitioner, nurse, hospital, or ambulance service provider that established or waived it shall, on written demand and at the expense of the patient, or the person by whom the patient was injured, or by the insurer obligated by reason of the injury, give a written release acknowledged before a notary public.
(b)(1) Any practitioner, nurse, hospital, or ambulance service provider that refuses or fails under the circumstances stated, for a period of five (5) days or more after a written demand is made for a release, to execute and deliver the release is liable to the demandant for injury or damage that results from refusal or failure.
(2) He or she shall forfeit to the demandant the sum of twenty-five dollars ($25.00), which may be recovered in an action for damages because of the failure, or in a civil action before a court having jurisdiction, as the circumstances of the case require.
Ark. Code Ann. § 18-46-115 Records of liens and releases.
(a)(1) At the expense of the county, the clerk of the circuit court in each county shall maintain a book record that is both designated and labeled "Medical, Nursing, Hospital, and Ambulance Service Provider Liens" and includes an index of properly labeled liens.
(2) A clerk shall make a record in the book record of liens filed in the order in which they are filed, noting the names and addresses of patients of practitioners, nurses, hospitals, ambulance service providers, other persons on whose behalf a notice of lien has been filed, tortfeasors, and insurers.
(3) If a clerk is authorized to electronically maintain records under § 13-4-301, he or she may maintain an electronic file only of the book record required under this subsection.
(b)(1) On the presentation of a release of a lien, the clerk of the circuit court of the county in which the lien is filed and recorded shall :
(A) Note on the file and in the book record the date when the release was filed; and
(B) Note on the release the fact that it has been so recorded.
(2) A release so noted or recorded in the book record in the office of the clerk of the circuit court shall be prima facie evidence of the release of the lien.
(c) The clerk of the circuit court shall collect the fee as prescribed in § 21-6-306, § 21-6-402, or § 21-6-403, whichever is applicable, for the filing of the release of any lien and noting on the record and on the release the fact that the release has been so filed.
Ark. Code Ann. § 18-46-116 Receipt and payment of money by court.
(a) Any court having jurisdiction in an action by a patient injured through the fault or neglect of another person against the person whose fault or neglect caused the injury or against an insurer obligated by reason of that injury, and if an action has not been begun, then any court having authority to entertain an action under the circumstances stated in this subsection, if and when an action is brought, on petition or other procedure conformable to the rules of practice of the court, by the tortfeasor or by the insurer who has been notified of a claim of lien under the provisions of this chapter, may receive and impound:
(1) The amount claimed by any practitioner, nurse, hospital, or ambulance service provider under the lien; or
(2) If no amount is named in the notice of the claim of lien that has been served, then the entire amount claimed by the patient from the tortfeasor or from the insurer or any less amount that the court deems sufficient to pay the amount claimed under the claims of lien or liens as have been served.
(b) The court may pay or distribute the money in accordance with that petition, motion, or judgment and pay any remaining balance to the person by whom the money was deposited:
(1) On joint motion or petition of the patient and the practitioner or practitioners, nurse or nurses, hospital or hospitals, and ambulance service provider or providers claiming interest in the money so paid into court; or
(2) On judgment by any competent court.
Ark. Code Ann. § 18-46-117 Pro rata payment of claims.
If the amount for which a tortfeasor or an insurer is liable to the patient on account of his or her injury is not sufficient to pay in full the claims of all practitioners, nurses, hospitals, and ambulance service providers that rendered service in the case and who have given notice of liens, then each practitioner, nurse, hospital, and ambulance service provider shall share in the amount payable to the patient in the proportion that his or her claim bears to the total amount claimed by all other practitioners, nurses, hospitals, and ambulance service providers.
Source: Public.Resource.Org / UniCourt, Official Code of Arkansas Annotated, Release 78 (2020) (unicourt.github.io/cic-code-ar)URL: https://unicourt.github.io/cic-code-ar/transforms/ar/ocar/r78/gov.ar.code.title.18.htmlFetched: 11/8/2026