Out-of-pocket health care expenses are one of the most pervasive barriers to health care and the cause of extreme financial hardship for people across Massachusetts and our entire country. Medical bills keep people from seeking medical care and crowd out other expenses like food, housing, and clothing. Race plays a role in medical debt, as well. People of color, particularly Black people, are far more likely to be burdened with unaffordable medical debt.

HLA’s Medical Debt Initiative is one of the busiest areas of our practice, with hundreds of consumers in low-income situations contacting us each year for help protecting them from improper medical billing and collection practices.

To shield people with low incomes from financial devastation due to medical expenses, HLA represents victims of illegal billing and advocates for reforms in health care provider practices and the law. Our clients include patients whose care providers billed, or even sued, them instead of billing their health plan as required. We also represent many consumers unlawfully denied benefits under charitable hospitals’ financial assistance policies.  

HLA lawyers regularly consult with hospital officials to assist them in complying with regulations on insurance screening, billing and collections for low-income patients. State officials also regularly seek HLA’s input when developing medical billing policies or considering enforcement of such regulations.


This work is supported by the Atrius Health Equity Foundation, the Blue Cross Blue Shield of Massachusetts Foundation and the Nord Family Foundation.