When Mass Health denied a mother’s claim for a special bed needed by her cerebral palsy-afflicted son, Health Law Advocates Inc. stepped in. In the end, the insurer reversed its decision and agreed to fund the bed that the woman would not have otherwise been able to afford.
That struggle for coverage is at the heart of the Boston non-profit’s mission: fighting for health care justice, a battle it wages with the help of pro bono attorneys. The success story above was nego-
tiated by Jeffrey N. Catalano, a medical malpractice attorney at Todd & Weld LLP in Boston and chair of the Massachusetts Bar Association’s Civil Litigation Section.
“They have a compelling mission. Health Law Advocates really is striving to make health care more accessible to everyone,” said Catalano, who began working with the organization two years ago and now sits on its board of directors.
“You’re making a difference in a very important area of the law,” said Catalano, who in his practice represents victims of catastrophic injuries in the areas of medical negligence, product liability, class action and other personal injury cases. “It’s a very rewarding experience to know you’re supporting someone’s basic need of health care.”
Health Law Advocates, which represents people who live or work in Massachusetts at or below 300 percent of the federal poverty level, is one of more than 100 organizations listed in the MBA Pro Bono Opportunities Guide. The guide, available online at www.massbar.org under the “For Attorneys” section, provides attorneys with key information about organizations seeking pro bono help and can be searched by geographic region and area of interest.
“We could not meet the needs of our clients without the pro bono legal network,” said Health law Advocates Staff Attorney/Legal Network Manager Matt Selig. The organization has seven full-time lawyers on staff.
The number of people contacting Health Law Advocates has grown significantly since it was founded 12 years ago, Selig said. Last year, nearly 850 people requested help from the organization. Selig expects those numbers to continue to climb now that Massachusetts requires all residents to have health care coverage.
More than 80 attorneys are currently signed on to take cases from Health Law Advocates and new lawyers are welcome and appreciated, Selig said. The commitment level depends on the individual lawyer’s skills and time, but the organization asks participants to take at least one case per year.
Typical cases involve a low-income individual who has been denied coverage of a service, drug or surgery and is seeking help, or someone who is struggling with medical debt because of a previous denial, Selig said. Cases can take less than five hours to more than 30 hours to resolve and could include phone calls, letters, appeals, informal negotiations and court hearings.
“We have something available for anybody depending on what they are able to handle,” Selig said.
New associates and those without health law experience are also welcome, Selig said. The organization can pair up those with less experience with more seasoned attorneys on staff or in the pro bono network.
“It really opens up the program to people who have little or no health law experience,” Selig said. “It’s a miscon-ception that you have to be a health lawyer to participate.”
Health Law Advocates, whose parent organization is Health Care For All, began in 1996 and is funded by private donations and foundation support, Executive Director Barbara Anthony said.
Clients find out about the organization in a number of ways, from its own Web site, the Health Care for All helpline and various legal and social service agencies. In addition to handling client cases, the organization works in education, outreach and with legislators.
“Health Law Advocates is all about giving consumers access to their health care coverage,” Anthony said. “Insurers often say no when the client should be covered under contract. Consumers are entitled to the coverage they were promised.”
That’s just the kind of case Lee M. Holland, an associate in the litigation group at Tarlow, Breed, Hart & Rodgers PC in Boston, accepted from Health Law Advocates last year, his first time working with the organization. A woman was battling with her insurer over coverage of a special consultation that would require her to go outside the insurance company’s approved network of doctors.
Even though the doctors within the network couldn’t offer the woman the care she needed, Holland said the insurer still refused to cover the consultation at the in-network rate. After negotiating with the insurer, Holland was able to secure the woman’s out-of-pocket costs.
“I wanted to do something outside of the billable hour where I was helping people,” Holland said of his reasons for joining the pro bono legal network at Health Law Advocates. “At the end of the day, I have a family and I understand what it is to have a medical need and have to fight to get coverage.”