February 21, 2008

Massachusetts Appeals Court Sides With HIV-Positive Girl

A Boston mother may soon win her legal battle with Massachusetts Medicaid provider MassHealth, which refused to pay for her daughter’s HIV-related neck surgery nearly four years ago, The Boston Globe reports (boston.com, 2/20). She took her case to the state’s Appeals Court, which has since sided with her as she seeks reimbursement from the state.

The mother, Elizabeth Shaw, paid for her daughter Ashley’s $2,000 surgery, which removed a fatty tissue deposit on her neck caused by HIV medication side effects. Because of the lump, Ashley had suffered from poor posture, headaches and an inability to sleep comfortably.

According to the Appeals Court, MassHealth cannot refuse retroactive payment of the bill if the surgery was medically necessary. A representative from the executive office of Health and Human Services declined to comment on this case to the Globe, but confirmed that it is currently under review.

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