October 4, 2007 -- Gay & Lesbian Advocates & Defenders (GLAD) will represent a teenaged girl when she appeals a lower court decision upholding MassHealth's refusal to pay for her HIV-related surgery. Oral argument in the Massachusetts Court of Appeals is scheduled for October 9, 2007 at 9:30 a.m.

GLAD had filed the suit in Suffolk Superior Court in 2005 on behalf of Ashley Shaw, and her adoptive mother, Liz Shaw. MassHealth, the state's Medicaid program, denied them payment for a medically necessary surgery to cure a painful condition caused by Ashley's HIV medications.

"Liz adopted a child with multiple, serious medical problems, who otherwise would have been in a state facility her entire life. Ashley clearly benefited -- but so did the Commonwealth," said Bennett Klein, GLAD's AIDS Law Project Director who is representing Ashley and Liz. "Liz saved the state hundreds of thousands of dollars by adopting and caring for Ashley -- but now the state is placing petty bureaucratic obstacles in her way as she tries to care for her child."

Ashley Shaw has lived with AIDS since her birth and takes powerful HIV antiviral medications that keep her alive. One side effect of the highly toxic drugs was the growth of an abnormal pad of fat on the nape of her neck, a condition causing severe headaches, neck pain and abnormal posture. The "buffalo hump" also impeded Ashley's ability to take part in sports and regular teenage activities. "Ashley cried daily and couldn't sleep because of the fat pad," said her mother.

Ashley's doctors at Children?s Hospital concluded the fat pad would cause permanent damage if left untreated in a growing child, and that surgical removal was the only effective medical treatment. Literally on the eve of the scheduled surgery, MassHealth denied coverage. In light of Ashley's pain and the risk of long-term damage, her mother made the decision to proceed, and then appeal MassHealth's denial.

The surgery was successful, but left Liz, a single mom and a visiting nurse, with a large bill. MassHealth reasoned that by proceeding with the surgery, she had waived her right to appeal the initial decision denying payment. The alternative would have been to delay the surgery indefinitely. Said Liz, "It can't make sense to ask a fifteen-year-old to live with a painful, dangerous condition in order to preserve her right to reimbursement."

In the lawsuit, Ashley Shaw v. Judy Ann Bigby and Beth Waldman, GLAD demands that MassHealth pay the costs associated with the procedure.

Gay & Lesbian Advocates & Defenders is New England's leading legal rights organization dedicated to ending discrimination based on sexual orientation, HIV status, and gender identity and expression.