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Insurance bureaucracies slow to catch up on new AAC devices

Posted Sep 15 2009 10:12pm

For Speech-Impaired, Insurance Fights Remedy. So goes the title of a New York Times story about people trying to get around some antiquated rules on speech devices.

If you are like me, when it comes to speech (or augmentative and alternative communication) devices, the image that comes to mind is often a big, dedicated device like a dynavox.

Times have changed, even for dynavox, who has a smaller device that includes wireless web browsing.

Even more, text-to-speech and icon based programs are available for laptops and, get this, the iPhone/iPod-touch.

Imagine a device that not only helps with communication, but can be surf the web and play games and videos and music and do even more. Imagine a device that has a “cool factor”. Imagine a device that fits in your pocket.

Can you imagine it? Well, it seems insurance companies can’t.

You see, if it can do something in addition to speech, it isn’t covered. If it hasn’t been approved yet, it isn’t isn’t covered. And, let’s face it, insurance companies aren’t that fast at approving new technology.

The funny thing is, this could save them money.

“We would not cover the iPhones and netbooks with speech-generating software capabilities because they are useful in the absence of an illness or injury,” said Peter Ashkenaz, a spokesman for the federal Centers for Medicare and Medicaid Services. Private insurers tend to follow the government’s lead in matters of coverage. Two years ago, iPhones and netbooks barely existed, so it may not be surprising that the industry has yet to consider their role as medical devices.

A dynavox system costs about $8,000. An system based on an iPod touch can be under $400 plus external speakers (I don’t think the speakers on the iPod touch would be loud enough if there is any background noise. But I could be wrong.)

One software product is Proloquo2Go, which works on the iPhone and iPod . I first heard about Proloquo2Go from a blog post on by Dora Raymaker.

But, remember, insurance companies aren’t paying for the iPod becuase it isn’t tested yet. That and they don’t like devices that do more than one thing. They dislike devices that do more than one task so much that they pay a lot extra ($8,000 vs. $500) and, get this, they turn off the extra features.

DynaVox, a leading maker of devices for the speech-impaired, has computers that start at $8,000 and run Windows, just like 90 percent of all PCs. To meet insurance rules, DynaVox disables the general computing tools. After the insurer pays, customers can pay $50 to DynaVox to reactivate the full functions.

This strikes me as bureaucracy getting in the way. Other devices, which would save the insurance company money, should be easy to test and get approved.

I just don’t get what the hold up is.

Thanks to a very cool reader who pointed me at this story.


This story is being picked up by a few other bloggers as well:

Disability Scoop, Insurers Balk At Modern, Low-Cost Assistive Technology

I4U, Medicare Denies Useful $150 App in Lieu of $8000 Machine, Medicare Would Rather Buy $8000 Computer than $150 iPhone App.

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