HIV-positive girl
sues to force Medicaid to pay for surgery

A 16-year-old HIV-positive Boston girl has filed a lawsuit against MassHealth, Massachusetts's Medicaid program, to force the program to pay for surgery to remove her HIV-related "buffalo hump," a side effect of antiretroviral drugs that gave the girl severe headaches, neck pain, and abnormal posture. The lawsuit was filed in Suffolk superior court by the Gay and Lesbian Advocates and Defenders, a gay- and HIV-rights group representing Ashley Shaw and her mother, Liz Shaw.

Ashley, who was infected with HIV during childbirth, was adopted by the Shaws when she was 3 months old and takes antiretroviral drugs to control her HIV infection. The development of a treatment-related fatty deposit on the nape of her neck, dubbed a "buffalo hump," needed to be surgically removed before it caused permanent damage to the adolescent, who is still growing, Shaw's doctors say. The "buffalo hump" also impeded Shaw's ability to take part in sports and regular teenage activities. "Ashley would cry daily and had trouble sleeping due to the fat pad," said her mother in a press release.

On the eve of a scheduled surgery to remove the fatty deposit, MassHealth denied coverage for the procedure. The family decided to proceed with the surgery anyway and afterward appeal MassHealth's denial of coverage and seek reimbursement. MassHealth ruled in the appeal process that by proceeding with the surgery the family waived any right to reimbursement by the health care program. The family is now suing MassHealth and Massachusetts government officials to force the state Medicaid agency to pay for the surgery.

"This is wrong as a matter of law and common sense," said Bennett Klein, GLAD's AIDS Law Project director, who is representing the Shaws. "The [Massachusetts governor Mitt] Romney administration can show compassion in its own backyard by making this right." (Advocate.com)