Manago v. County of Cook, 92 N.E.3d 412

Background

Akeem Manago (12 at injury) was treated at John H. Stroger, Jr., Hospital for injuries from "elevator surfing." The hospital (via Cook County) filed a health-care lien under the Health Care Services Lien Act (Lien Act) for unpaid bills (~$79,572.53).
The minor sued tortfeasors; the second amended complaint alleged the mother had incurred medical expenses but did not plead a claim for those expenses. The minor later became an adult; caption amended to show both Akeem and his mother as plaintiffs but the complaint was not changed.
At bench trial the court awarded damages to the plaintiff but declined to award medical-expense damages to the mother; posttrial, the court struck, dismissed, and extinguished the hospital’s lien. Cook County (on behalf of the hospital) appealed.
The appellate court initially reinstated the lien (Manago I), then after supplemental briefing reversed and affirmed extinguishment (Manago II), reasoning the Lien Act did not apply absent a parental assignment and because liens attach only to recoveries for medical expenses.
The Illinois Supreme Court granted leave, addressed whether the Lien Act permits a health-care lien to attach to a minor’s recovery absent a parental assignment or an award explicitly for medical expenses, and reversed the appellate court, holding the hospital was entitled to a lien under the plain terms of the Lien Act.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a Lien Act health-care lien can attach to a minor’s recovery absent an assignment of the parent’s cause of action for medical expenses	Manago: lien cannot attach because parents, not minors, have the right to recover medical expenses under the Family Expense Act; without assignment lien is invalid	County (hospital): Lien Act language grants a lien on “all claims and causes of action of the injured person” and attaches to verdicts/settlements secured by or on behalf of the injured person, including minors	Held: Lien Act’s plain, unambiguous language allows a lien to attach to a minor’s recovery absent parental assignment; court reversed appellate judgment and remanded
Whether a health-care lien applies only to recoveries expressly awarding medical expenses	Manago: lien limited to recoveries for medical expenses because Lien Act refers to provider’s charges “for the amount of” reasonable charges; no medical-expense award here, so no lien	County: Lien Act attaches to "verdict, judgment, award, settlement, or compromise secured by or on behalf of the injured person" without conditioning on an explicit medical-expense award	Held: Lien Act is not limited to sums expressly allocated as medical expenses; lien may attach to a minor’s overall recovery consistent with statute’s plain language
Whether the Lien Act must be read to avoid conflict with the Family Expense Act by adding limitations (age or parental-rights exceptions)	Manago: statutes conflict; courts should harmonize so parental exclusivity over medical-expense claims prevents Lien Act liens on minor recoveries absent assignment	County: no conflict—statutes have distinct purposes and both can operate independently; court should enforce plain statutory language rather than add exceptions	Held: No judicially imposed limiting language is warranted; statutes coexist and the Lien Act’s plain terms control; harmonization does not require adding conditions

Key Cases Cited

In re Estate of Cooper, 125 Ill. 2d 363 (1988) (discusses Lien Act’s purpose and lien as property interest)
Wendling v. Southern Illinois Hospital Services, 242 Ill. 2d 261 (2011) (interpreting lien calculations under Lien Act)
Graul v. Adrian, 32 Ill. 2d 345 (1965) (parental right to recover child’s medical and funeral expenses under Family Expense Act)
Enloe v. 109 Ill. App. 3d 1089 (1982) (holds Lien Act and Family Expense Act provide alternative remedies; no inherent conflict)
Kennedy v. Kiss, 89 Ill. App. 3d 890 (1980) (minor assigned parent’s cause of action steps into parent’s shoes and is subject to same defenses)