Why won't Massachusetts attorneys represent me in my struggle to get the curative medication (Harvoni) that I need?

2 views 2 answers
My HMO has denied coverage for Harvoni, which can cure my Hepatitis C, because I'm "too healthy". Why are Massachusetts attorneys, or any attorney for that matter, so afraid to represent me? What are attorneys so afraid of?

Attorney Answers

2
Thomas Callahan ·
This is not a function of anyone being afraid to sue an HMO. There are plenty of attorneys who have sued HMOs and probably a lot who relish it. The inability to get someone to take your case may be because of any one, or a combination of these factors, 1) you haven't exhausted the administrative process within the HMO, 2) maybe you do not have a strong legal case on the merits despite your opinion of same, 3) I doubt that such a case would be taken on a contingency fee basis, and so it may involve your ability to pay; attorneys cannot work for free despite the seeming belief we are all rich and can afford to work for nothing,, 4) a cost--benefit analysis of factors 2 & 3 since this case may be expensive and likely requires the hiring of a medical expert. Although this is not a medical malpractice case, I suggest you seek out such an attorney since assessing the merits of your case from both medical and legal points of view, access to experts and possible ability to have the resources to take on this case would all be most closely analogous to taking on a med mal case.
0 upvotes
Eliot Wolf ·
Your HMO should have an appeals process which needs to be followed. If there are no other Hep C treatments available to you, then with medical documentation and support perhaps you can get the HMO to reverse itself. I am sure with hourly retainer you can get counsel to represent you but this may be expensive to pursue in that manner.
0 upvotes