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Shaw v. Murphy

Victory

Overview

On February 19, 2008, the Massachusetts Court of Appeals ruled in favor of Ashley Shaw, who has sought to get MassHealth to cover her medically necessary HIV-related surgery. When Ashley was 15, her doctors recommended the surgical removal of a fat pad from her neck, a side-effect of her HIV medications. MassHealth denied coverage on the eve of the surgery, and argued that Ashley had waived any right to reimbursement because her mom decided to go ahead with the surgery before exhausting all appeals.

A Massachusetts Superior Court Judge sided with MassHealth, and GLAD appealed. GLAD argued, and the Appeals Court agreed, that MassHealth must review the medical necessity of the procedure. MassHealth has agreed to pay for the surgery.

Case Documents