Thanks to your generous support, HLA represented more than 1,500 clients in 2022. Here are stories behind two of those cases. 

Tijon, Age 12

Nicole is 12-year-old Tijon’s mom. When Tijon was younger, he was diagnosed with a rare neurodegenerative disorder called PKAN (pantothenate kinase-associated neurodegeneration) that impacts his physical skills, such as his ability to walk, talk, and swallow, his social and emotional functioning, and his vision. PKAN will also affect his life expectancy and, over time, will continue to influence all his areas of functioning. 

Last year, Tijon was having increased difficulty getting around at his school, engaging academically in his classes, and interacting with his peers. Despite his struggles, Tijon’s school wasn’t providing the accommodations that Nicole felt were necessary for Tijon’s continuously changing needs. So, in March 2022, Nicole reached out to HLA’s Mental Health Advocacy Program for Kids (MHAP for Kids) and their case was immediately assigned to Staff Attorney Kendal Poirier. 

Kendal attended an IEP meeting at Tijon’s school when they were reviewing his progress and she advocated for a change in placement to a therapeutic placement that Nicole felt would much better accommodate Tijon’s diagnosis and his unique needs as the disease progresses. The school district agreed and Kendal supported Nicole and Tijon in selecting the school that was the best fit for him. Kendal kept at it and attended a six-week post-admission team meeting at Tijon’s new school, which specializes in traumatic brain injuries and neurobehavioral disorders; and secured an increase in physical therapy services for him. 

Tijon started at his new school in September, where he continues to do well and was even elected class president!

“I was so grateful to know that Kendal was just a phone call away, she was really there for us. I could call her about anything. Even when she had appointments, she always made herself available. When they [the school] were changing things [in his IEP], I’d call her, and Kendal would contact them right away. When the school said things like, ‘Well we can try’, Kendal would say, “No, we’re not going to wait.’ She was on top of anything.”

- Nicole

Matthew is 63 years old and lives in Barnstable County. In January 2022, Matthew broke his leg while traveling out of state and was rushed by ambulance to a hospital. He was told that he needed surgery right away. Unfortunately, they couldn’t reach the orthopedic surgeon and Matthew discharged with a soft cast.

The following day, the surgeon called Matthew and advised him to return for surgery or else he wouldn’t be able to safely travel back home. Matthew went back to the hospital and gave the hospital his insurance card.

After returning home, Matthew received a copy of an email from his health plan notifying the orthopedic surgeon that their services would not be covered. The surgeon subsequently billed Matthew. He also received a bill for the ambulance ride, which the health plan refused to cover, as well as a bill from another doctor at the hospital who received partial payment from Matthew’s health plan. The bills totaled over $28,000.

Matthew reached out to HLA and the case was assigned to Senior Supervising Attorney Wells Wilkinson. Wells investigated Matthew’s health plan documents and the explanation of benefits (EOB) he received after his accident. The EOBs stated that because the emergency services Matthew received were provided by out-of-network providers, the health plan would cover virtually none of the bills and Matthew would have to pay them himself.

Fortunately, as of January 1, 2022, consumers have billing protections when receiving emergency care from out-of-network providers under the federal No Surprises Act, which includes safeguards against having to pay these bills out-of-pocket.

Wells contacted the hospital, surgeon and ambulance company who were billing Matthew for the costs of his emergency care. Wells informed them that their billing was prohibited by law and asserted Matthew’s rights under federal and state law for full coverage of the emergency services. Wells also contacted Matthew’s health plan, arguing that all of Matthew’s emergency services should have been covered.

Ultimately, the health plan reprocessed all of Matthew’s claims, and paid those that had been denied, covering the entire $28,820 debt.

“When I got off the phone with Wells, I thought it [my case] wouldn’t go anywhere. I panicked, and overplayed it in my mind: I thought I’ll have to go into a payment plan – I thought it’d be nightmare. But, Wells was great. A week later I got another email from him. Within a week or two, he would keep me updated regularly, clear and concise, saying, ‘It looks like you have a good case, you definitely were in the right’.”

- Matthew

In 2022, HLA represented 1,379 clients with a known address all across our state. Our clients last year included residents of 219 different Massachusetts cities and towns. The municipalities highlighted green are ones in which we served a client in 2022, with the darker shades representing a higher number of cases in that city/town.

Boston: 164

Springfield: 57

Lowell: 52

Haverhill: 32

Holyoke: 31

Worcester: 31

New Bedford: 30

Brockton: 26

Cambridge: 26

Fall River: 25

Framingham: 25

Lynn: 24

Lawrence: 22

Quincy: 21

Malden: 20

Pittsfield: 19

Fitchburg: 17

Marlborough: 17

Gardner: 16

Methuen: 16

Beverly: 15

Weymouth: 15

Brookline: 13

Chelsea: 13

Chicopee: 13

Leominster: 13

Somerville: 13

Waltham: 13

Arlington: 12

Dracut: 12

Taunton: 12

Wareham: 12

Milford: 11

Everett: 10

Greenfield: 10

Medford: 10

Woburn: 10

Billerica: 9

Peabody: 9

Plymouth: 9

Randolph: 9

Southbridge: 9

Foxborough: 8

Northbridge: 8

Palmer: 8

Saugus: 8

Attleborough: 7

Barnstable: 7

Revere: 7

Sudbury: 7

Westfield: 7

Braintree: 6

Bridgewater: 6

Canton: 6

Douglas: 6

Milton: 6

Norwood: 6

Amherst: 5

Dartmouth: 5

Gloucester: 5

Hudson: 5

Middleborough: 5

Newton:  5

North Attleborough: 5

Salem: 5

Webster: 5

Westport: 5

Wilmington: 5

Ashland: 4

Athol: 4

Ayer: 4

Belchertown: 4

Belmont: 4

Fairhaven: 4

Hanover: 4

Marblehead: 4

North Andover: 4

Oxford: 4

Stoneham: 4

Stoughton: 4

Watertown: 4

West Springfield: 4

Whitman: 4

Winchendon: 4

Yarmouth: 4

Agawam: 3

Avon: 3

Bourne: 3

Boxford: 3

Chelmsford: 3

Cohasset: 3

Danvers: 3

Easton: 3

Falmouth: 3

Franklin: 3

Grafton: 3

Hingham: 3

Lakeville: 3

Mattapoisett: 3

Medway: 3

Natick: 3

North Adams: 3

Northborough: 3

Rockland: 3

Rockport: 3

Sharon: 3

Sturbridge: 3

Templeton: 3

Wakefield: 3

Ware: 3

Westborough: 3

Winthrop: 3

Amesbury: 2

Auburn: 2

Barre: 2

Bellingham: 2

Charlton: 2

Chatham: 2

Clinton: 2

Dedham: 2

Dennis: 2

Dighton: 2

Dunstable: 2

East Bridgewater: 2

Easthampton: 2

Erving: 2

Hadley: 2

Holbrook: 2

Holden: 2

Hopkinton: 2

Hull: 2

Lancaster: 2

Lee: 2

Lexington: 2

Littleton: 2

Ludlow: 2

Millbury: 2

Millis: 2

Montague: 2

Northampton: 2

Orange: 2

Pepperell: 2

Plainville: 2

Princeton: 2

Reading: 2

Shrewsbury: 2

Somerset: 2

South Hadley: 2

Stow: 2

Tewksbury: 2

Tyngsborough: 2

Walpole: 2

Wellfleet: 2

West Boylston: 2

Abington: 1

Acton: 1

Acushnet: 1

Andover: 1

Ashburnham: 1

Berkely: 1

Blackstone: 1

Bolton: 1

Boxborough: 1

Brewster: 1

Brookfield: 1

Buckland: 1

Burlington: 1

Carver: 1

Clarksburg: 1

Deerfield: 1

Dudley: 1

East Brookfield: 1

East Longmeadow: 1

Essex: 1

Franklin: 1

Freetown: 1

Granby: 1

Great Barrington: 1

Hampden: 1

Hardwick: 1

Holliston: 1

Ipswich: 1

Kingston: 1

Lanesborough: 1

Leicester: 1

Lenox: 1

Lincoln: 1

Mansfield: 1

Mashpee: 1

Maynard: 1

Melrose: 1

Mendon: 1

Merrimac: 1

Monson: 1

North Brookfield: 1

North Reading: 1

Oakham: 1

Orleans: 1

Pembroke: 1

Provincetown: 1

Rowley: 1

Royalston: 1

Russell: 1

Sandwich: 1

South Dartmouth: 1

Southampton: 1

Sterling: 1

Swansea: 1

Tisbury: 1

Uxbridge: 1

Wendell: 1

West Bridgewater: 1

West Newbury: 1

West Stockbridge: 1

Westhampton: 1

Weston: 1

Wilbraham: 1

Williamsburg: 1

Worthington: 1

Approximately 22% of HLA clients’ primary language is a language other than English. In the course of representing our clients we oftentimes see health care entities providing our clients with important documents and other information without translation or interpretation into their preferred language. This gap in language access is a major barrier to health care for many people and HLA has been advocating for our health care system to better serve people with limited English proficiency.

One important aspect of our health system where we’ve advocated extensively for improved language access is the MassHealth program which provides health insurance for more than two million Massachusetts residents. HLA Supervising Attorney Kate Purrington has been instrumental in pushing for greater language access within MassHealth, with other advocacy organizations we work with, and we have seen some changes over the past year, including a process to request documents in other languages free of charge over the phone.

HLA has also raised concerns with MassHealth about members receiving notices, including notices of termination of coverage, in a language the member doesn’t read/speak. In response, MassHealth has started developing a system where notices are translated into more languages. This is crucial because MassHealth will soon be re-determining all members’ eligibility for the first time since the beginning of the pandemic and members will be asked to respond to notices to keep their coverage. 

HLA is continuing to advocate for compliance with the law regarding language accessibility throughout our health care system in 2023.

Since our last quarterly newsletter in October, HLA staff have conducted 29 training programs for consumers in low-income situations, as well as health, social service, and legal service providers. The topics of our outreach and training programs vary widely and include children’s rights to access mental health services, health care access for immigrants, and numerous other topics related to health care access.

HLA’s Deputy Director Marisol Garcia presenting at the Children’s Hospital Association’s

Behavioral Health Summit in Minneapolis

In October, HLA’s Deputy Director Marisol Garcia presented at the Children’s Hospital Association’s Behavioral Health Summit in Minneapolis. This national conference gathered minds in behavioral health care to share challenges and discuss solutions on how we can best support children’s behavioral health. Marisol participated in a panel discussion called “Community Collaboration and Advocacy”, where she and other panelists from hospitals and community organizations described how they worked together to serve children experiencing complex behavioral health concerns. Marisol spoke about how HLA’s Mental Health Advocacy Program for Kids (MHAP for Kids) works closely with Boston Children’s Hospital, and its MassHealth accountable are organization, to improve children’s mental health by reducing barriers to treatment in our mental health system. 

Our MHAP for Kids Senior Supervising Attorney Eliza Presson also promoted our partnership with Boston Children's Hospital in a published article. The piece, published by the American Bar Association's Children's Rights Litigation Committee, aims to help other legal advocates and health care providers form partnerships to help children with mental illness.

(Left to Right) From Boston Children's Hospital, Katherine Engel, Alexia Edwards, Amara Anosike, and Miranda Collura pictured with HLA’s Deputy Director Marisol Garcia at the Children’s Hospital Association’s

Behavioral Health Summit in Minneapolis

In November, HLA Staff Attorney Jennifer Cedor spoke at the “Spread the Health: Navigating the Health Insurance Marketplace” event sponsored by Point32Health and the Boston Celtics, through their Boston Celtics United for Social Justice effort. Other panelists joining Jennifer included staff members from Health Care For All and a representative from Point32Health. The speakers discussed ways to navigate the health insurance enrollment process, particularly for the Black and Brown community. The panel was moderated by Celtics Sideline Reporter Abby Chin of NBC Sports Boston.

(Left to Right) Panelists Patrick Cahill of Point32Health, Luby O'Connor and Hannah Frigand of Health Care for All, HLA Staff Attorney Jennifer Cedor, and Moderator Abby Chin of NBC Sports Boston at the Spread the Health: Navigating the Health Insurance Marketplace” event sponsored by Point32Health and the Boston Celtics

Year End Fundraising Drive

Thank You to the Following Donors for Contributing to our

2022 Year-End Drive Which Raised More Than $100,000 for our Work to Expand Access to Health Care!

• Anonymous
• Maria Rosario González Albuixech
• Jacquie Anderson
• Aon
• Jeannette Atkinson
• Lauren & Tony Barnes
• Lauren Barnes
• Emily Brice
• Barbara Buell
• Barbara Carboni
• Ugo Chukwueke & Sam Botsford
• Arva Clark
• Thomas & Geraldine Crane
• Catlin Donnelly
• James Dorsey
• Catherine Dunham
• Patricia Edraos
• Alan Einhorn
• Kathy Eklund
• Lynne Ellis
• Margaret & Peter Enrich
• Richard Frank
• Don Freedman
• Cindy Friedman
• Jennifer Gallop
• Gail Garinger
• Alan Geismer
• Scott Glidden
• Norbert Goldfield
• Stephen Gorrie

• Josh Greenberg & Kate Dulit
• Matt Herndon
• Donald & Patricia Hillman
• Allison Hoffman
• Kristen Johnson
• Catherine Keyes
• Tira Khan
• Bennett Klein
• Mary Kraft
• Larry Kraus
• Robert Lamarca
• Ann Lambert
• Erin Lanzo
• William Lawson & Elizabeth Lowry
• Mary Kay Leonard
• Jenny Littlefield
• Renee Loth
• Justin & Aly Lowe
• Robert Melia
• Francesca Miceli
• Mollie Baldwin Foley Charitable Trust
• John & Lucia Mudd
• Alice Pierce
• Plymouth Rock Foundation
• Point 32 Health
• Mala Rafik
• Allan Rodgers

• Nina Rosenberg
• Robert Russell
• Mary Ryan
• Robert Sable
• Peter Saradjian
• Bert Seager & Renee Loth
• Andrew Seligsohn
• Marla Shatkin & Henry Margolis
• William Shaw
• Patrick Sheehan
• Stephen Shestakofsky
• Jennifer Siegel
• Maxwell Solet
• Shelley Steuer
• Betsy Stoll
• Stephen & Joan Subrin
• Jean Sullivan
• Andrea Sweet
• David Szabo
• Diane Tillotson
• Mitchell & Barbara Freedman Wand
• Wendy Warring
• Amy Weinstock
• Ben Wilson

Now, well into its third year, our DEI Committee is led by our two new Co-Chairs, Staff Attorneys Kara Hurvitz and Kendal Poirier. In addition to the Co-Chairs, the Committee’s steering team includes Paralegal Ignacio Velez and Staff Attorney Caitlin Reed. Some of their recent efforts include:

• Finalizing new fliers for distribution to expand our visibility among potential community partners and clients.

• Developing protocols that are designed to improve our outreach to communities we know are underserved.

• Securing training for HLA’s staff from the Massachusetts Legal Assistance Corporation (MLAC) to help us address microaggressions in the workplace.

• Leading staff discussions around anti-racist practices using Dr. Ibram X. Kendi’s Be Anti-Racist workbook.