--------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300000Date: 12/01/97 From: GTRAPP@ABQ.COM Time: 09:54am \/To: ALL (Read 0 times) Subj: Medical Insurance From: gtrapp@abq.com Subject: Medical Insurance NOTE: The following is informational only, and does not constitute legal advice. Only an attorney licensed in your state will be able to give you legal advice. Your state's Protection & Advocacy System may be able to help you, or give you the names of lawyers in your state who are familiar with disability law. Dear Peter, Rene, and NFB-Talk Listers, Peter Donahue commented on an article I wrote which appears in the November Braille Monitor. The article deals with acquiring medical insurance funding for a CCTV. Peter asks if the reasoning allowing for medical insurance funding of a CCTV could also apply to other types of adaptive technology, such as speech synthesizers or braille display devices. Unfortunately, since insurance companies generally consider such items to be "convenience" items, they are normally not within the scope of medical insurance coverage. I first want to preface my remarks by saying that I have been the Protection & Advocacy for Assistive Technology Attorney in New Mexico for the last 3 years. I would like to think that I am on the cutting edge of the law as it relates to the funding and acquisition of assistive technology. Also, since I have only light perception and cannot use a CCTV myself, I have no personal bias in favor of a CCTV. I would like to applaud Peter for his creative suggestion in wanting to have a wider range of adaptive technology covered by medical insurance. Unfortunately, it would presently be very difficult, if not virtually impossible, to accomplish such a goal. Indeed, at present, even persons seeking medical insurance funding of a CCTV can usually expect to have to appeal through numerous levels of appeal stages, even though a CCTV should clearly be a covered item. It is my belief that medical insurance funding of most items of adaptive technology should usually be a payer of last resort, especially if there is a lifetime cap on the amount of insurance coverage. For most persons, it will be much easier to obtain funding from a vocational rehabilitation agency, from an employer as a reasonable accommodation, or from a school district as a part of an IEP. Others may decide to pursue private funding from civic groups or pay from their own personal resources, especially if the adaptive technology is less expensive, such as the CCTV's that hook up to an existing television. Yet, for some persons, such as an elderly person who does not have an employment goal, the only practical funding source may be medical insurance. Under Medicare, for a device to be covered as durable medical equipment (DME), it must be able to withstand repeated use, be primarily and customarily used to serve a medical purpose, be generally not useful to an individual in the absence of an illness or injury, be appropriate for use in the home, and be necessary and reasonable for the treatment of an illness or injury or to improve the functioning of a malformed body member. The Medicare requirements are typical of most insurance carriers. However, most items of adaptive technology cannot be an item of DME because they do not meet all of the required criteria. For instance, a reading machine, an item of adaptive technology which is similar to a CCTV in purpose, is not primarily and customarily used to serve a medical purpose. The primary use of a reading machine is not medical. Doctors do not prescribe reading machines, doctors do not supervise their use, and reading machines are not sold by drug stores or medical supply companies. If a reading machine serves a medical purpose, than so could light probes, money identifiers, tape recorders, speech synthesizers, braille watches, braille printers, and a host of other adaptive aids and appliances. By contrast, a CCTV is similar to cataract lenses in that it enhances available vision, giving it a more obvious medical purpose. The question really gets tricky when it comes to looking at the criteria that it be "necessary and reasonable for the treatment of an illness or injury or to improve the functioning of a malformed body member." Setting aside the requirement that it serve a medical purpose, the best argument is that a reading machine is a "prosthetic device" which "substitutes for the functioning of a malformed body member." It may be useful at this point to consider how augmentative communication devices are often funded. What typically happens is that the issue turns on the requirement of the person to communicate their medical needs. Thus, an augmentative communication device substitutes for the functioning of the voice box, and is "medically necessary" for the treatment of the individual. Without an augmentative communications device, a person who cannot otherwise communicate could try in vain for hours to communicate an urgent medical need. By contrast, while a reading machine might be used to read a drug information sheet, that same information could be communicated in a few seconds by the doctor, pharmacist, reader, or relative. For these reasons, most items of adaptive technology are considered to be "convenience" items, and not covered by medical insurance. However, to confuse matters more, the argument that a particular device is medically necessary because it allows communication of medical needs should not be determinative, as the real issue is the function that is served, not the material that is read or communicated. My purpose in writing the CCTV article was to expand the types of CCTV funding options that are available to blind persons. It is my ultimate hope to expand the range of assistive technology that can be funded through medical insurance. As funding of CCTV's becomes more accepted, perhaps other types of adaptive technology can also be funded by medical insurance. In the meantime, some persons may by chance be able to obtain medical insurance funding of an item of adaptive equipment such as a reading machine. However, my preference would be to first lay a solid foundation. Establishing routine medical insurance funding of CCTV's would help lay such a foundation. Greg Trapp --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300001Date: 12/01/97 From: RICHARD WEBB Time: 06:48pm \/To: ALL (Read 0 times) Subj: mark_schowalter.parti@ecunet.org From: Richard Webb Subject: mark_schowalter.parti@ecunet.org Hello Greg and listers. Recently, you wrote: >I would like to applaud Peter for his creative suggestion in >wanting to have a wider range of adaptive technology covered by >medical insurance. Unfortunately, it would presently be very >difficult, if not virtually impossible, to accomplish such a goal. >Indeed, at present, even persons seeking medical insurance funding >of a CCTV can usually expect to have to appeal through numerous >levels of appeal stages, even though a CCTV should clearly be a >covered item. A good explanation of the situation. My question deals with some later comments though, which I'll quote below. >Under Medicare, for a device to be covered as durable medical >equipment (DME), it must be able to withstand repeated use, be >primarily and customarily used to serve a medical purpose, be >generally not useful to an individual in the absence of an illness >or injury, be appropriate for use in the home, and be necessary and >reasonable for the treatment of an illness or injury or to improve >the functioning of a malformed body member. The Medicare >requirements are typical of most insurance carriers. >However, most items of adaptive technology cannot be an item of DME >because they do not meet all of the required criteria. For >instance, a reading machine, an item of adaptive technology which >is similar to a CCTV in purpose, is not primarily and customarily >used to serve a medical purpose. The primary use of a reading >machine is not medical. Doctors do not prescribe reading machines, >doctors do not supervise their use, and reading machines are not >sold by drug stores or medical supply companies. If a reading >machine serves a medical purpose, than so could light probes, money >deletia> >braille printers, and a host of other adaptive aids and appliances. Here's an interesting one for you. My significant other, I guess you'd put it, is a diabetic. She's not blind at the moment, but I've found myself a few times wishing I could just have her flip me a finger, get some blood, and run the bg check for her without having to wake her. I've also found a situation where I couldn't get her conscious, and a talking blood glucose monitor would have been helpful. COuld she possibly argue with her insurance carriers that because of her medical condition and my blindness, she should really have one talking bg meter available? >What typically happens is that the issue turns on the requirement of the >person to communicate their medical needs. Thus, an augmentative >communication device substitutes for the functioning of the voice >box, and is "medically necessary" for the treatment of the >individual. Without an augmentative communications device, a >person who cannot otherwise communicate could try in vain for hours >to communicate an urgent medical need. By contrast, while a >reading machine might be used to read a drug information sheet, >that same information could be communicated in a few seconds by the >doctor, pharmacist, reader, or relative. For these reasons, most >items of adaptive technology are considered to be "convenience" >items, and not covered by medical insurance. However, to confuse There again, if she's unconscious, the first thing I want to judge is whether or not she's in need of insulin or in need of sugar. An adapted glucometer is available, but is spendy. My theoretical argument also hinges on communication of a medical need. A knowledgeable spouse or relative could use the meter she has to ascertain that information, and make intelligent decisions about whether to seek help for her. Regards, Richard Webb Electric Spider Productions Net-Tamer V 1.08.1 - Test Drive --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300002Date: 12/01/97 From: FLOWERS@TELAPEX.COM Time: 07:44pm \/To: ALL (Read 0 times) Subj: special Announcement From: flowers@telapex.com Subject: special Announcement SPECIAL ANNOUNCEMENT All former students and friends of the Mississippi School for The blind, which began at the Pineywood school in 1929 and later moved to Jackson on Capers Avenue, who wish to attend the 1999 Reunion and Founder's Day celebration should contact: Mrs. Patricia White Montgomery 745 Neering Trail Jackson, MS 39206 Phone: 601-982-8802 The celebration will be held September 2 thru 5 1999. Your prompt response is needed. Also, you can e-mail flowers Bates at flowers@telapex.com. --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300003Date: 12/02/97 From: GTRAPP@ABQ.COM Time: 01:29am \/To: ALL (Read 0 times) Subj: Medical Insurance From: gtrapp@abq.com Subject: Medical Insurance Dear Listers, Well, my response to Peter has generated some interesting comments. Richard asked about funding of a talking glucometer for his significant other, who is a sighted diabetic. This is certainly a subject I can empathize with, as my sighted mother is a very brittle diabetic, and I frequently must pull her out of insulin reactions. On those occasions, I have desperately wished for a talking glucometer. Of course, a blind diabetic can certainly get medical insurance coverage of a talking glucometer. However, if Richard is his significant other's care giver, than I would think that Richard could probably get a talking glucometer funded through her insurance, though it may take some convincing. The best argument is probably that the item is necessary in order for Richard to provide her with proper care, and that a talking glucometer would prevent trips to the emergency room, hospitalizations, or the potential complications of uncontrolled blood sugar. Naturally, the fact that this would save the hospital money would help. Such arguments might have to be raised on appeal of an initial denial. I am certainly not an expert on talking glucometers, so I would suggest that persons interested in talking glucometers contact the NFB Diabetic Division to find out about the latest developments in this area. As for Al's comments, I absolutely agree that the differences between what is allowed and what is disapproved is sometimes esoteric. Greg --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300004Date: 12/02/97 From: EMPOWER@SMART.NET Time: 12:02pm \/To: ALL (Read 0 times) Subj: gtrapp@abq.com From: empower@smart.net Subject: gtrapp@abq.com Medical Insurance Greg, Just wanted to express my appreciation for the quality of your Monitor article and follow-up on this subject! Regards, Jamal Net-Tamer V 1.09.2 - Registered --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300005Date: 12/02/97 From: LINWOOD GALLAGHER Time: 05:41am \/To: DUANE IVERSON (Read 0 times) Subj: both sides of a coin Dear Duane: It is a pleasure to hear from someone who can appreciate the trials and tribulations of developers. It seems to me that I keep hearing about what technology won't do rather than what it will do. While it is true that speech packages can cost $1,000 to $2,000; I think beginners should be advised that in some instances a file reader can be a modest introduction especially when family members have a com- puter and a family member who is print disabled is feeling left out. --- Maximus 3.01 * Origin: Library COM -* Reno, NV USA *- (702) 785-4191 (1:213/742) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300006Date: 12/02/97 From: "CHARLES (CHUCK) OPPERMANN" Time: 10:51am \/To: ALL (Read 0 times) Subj: Microsoft Announces Internet Explorer 4.10:51:2212/02/97 From: "Charles (Chuck) Oppermann" Subject: Microsoft Announces Internet Explorer 4.01! (Forward From dandrews@visi.com) Microsoft is proud to announce the release of Internet Explorer 4.01! This release of Internet Explorer adds full support for Microsoft Active Accessibility(tm) and fixes many accessibility-related problems with the initial release of Internet Explorer 4.0. Microsoft has made this new release available on our web site, http://microsoft.com/ie/. Internet Explorer 4.01 replaces version 4.0 that has been available since September 30. The CD-ROM version will be updated as well. In addition to the already existing support for user authored style sheets, control over font color, size and type and the many accessibility features introduced with Internet Explorer 3.0 last year, Internet Explorer 4.01 adds the following: * Full support for Microsoft Active Accessibility, including the HTML document area, the Active Desktop, and new "Menu bands" * Active Desktop is keyboard accessible and the Microsoft Channel Bar includes keyboard access and MSAA support * The new HTML help system is accessible via the keyboard * Full-screen mode can be toggled with the F11 key to provide access to the menu band. * System Caret position updated when a screen reader is present or through an advanced option setting * ALT attribute information can be fully expanded when running a screen reader or through an advanced option setting and ALT attribute text is shown using the correct text colors, including link color * Advanced Options dialog now show "On" or "Off" when running a screen reader * High Contrast settings are now compatible with Internet Explorer 3.0 This release of Internet Explorer includes full support for Microsoft Active Accessibility. This support was planned for the 4.0 release, but was delayed due to quality and technical issues. Microsoft apologizes for the delay in fully supporting Active Accessibility in such an important product. The Active Accessibility support in Internet Explorer 4.01 is more complete that what was available with Internet Explorer 3.0. More information is available about the HTML document and new features of the HTML 4.0 specification are now exposed such as the LABEL and TITLE attributes. Included in the Internet Explorer 4.01 package is the Microsoft Java Virtual Machine (VM) which includes full support for Microsoft Active Accessibility and the new Active Accessibility for Java. Internet Explorer 4.01 requires Microsoft Active Accessibility version 1.1. The Active Accessibility Redistribution Kit (RDK) is available from the Microsoft Accessibility and Disabilities FTP site at ftp://ftp.microsoft.com/mscorp/enable/msaardk.exe or from your accessibility aid vendor. Your accessibility aid might also need to be updated to support the new features present in Internet Explorer 4.01. Please contact your vendor for details. There is a comprehensive Reference Guide to using Internet Explorer 4.01 by people with disabilities. You can download an electronic copy from our web site at http://microsoft.com/enable/products/ie4.htm. For more information on Internet Explorer 4.01, please go to http://microsoft.com/ie/. For a description of 4.01 accessibility features, go to http://microsoft.com/ie/ie40/features/?/ie/ie40/features/ie-acsbl.htm. For the official press release on Internet Explorer 4.01, read http://microsoft.com/corpinfo/press/1997/Dec97/IE401Pr.htm. To download Internet Explorer 4.01 for Windows 95 or Windows NT 4.0, go to http://microsoft.com/ie/ie40/download/win95.htm. Microsoft is committed to making our products and services usable by everyone. Please help us accomplish that goal by sending us any comments on this or any other Microsoft product. You can write us at enable@microsoft.com or for more technical questions, abletech@microsoft.com. On behalf of the Microsoft Internet Explorer team and the Accessibility and Disabilities group, we hope you will enjoy Internet Explorer 4.01, the most accessible graphical web browser available! This message is being sent to several different email lists and to many individuals. Please do not cross-post without checking to see if the message has not already been copied. Charles Oppermann Program Manager, Active Accessibility, Microsoft Corporation mailto:chuckop@microsoft.com http://microsoft.com/enable/ "A computer on every desk and in every home, usable by everyone!" --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300007Date: 12/03/97 From: BPROWS@OS.DHHS.GOV Time: 08:35am \/To: ALL (Read 0 times) Subj: re: NFB-TALK Digest From: Subject: re: NFB-TALK Digest Hi, I think I have read the "Special Announcement" message from Flowers@telapex.com about ten or more times. Sounds like a great elebration- -I almost wish I had gone to the Mississippi school. I'll be sure to tell anyone I find from Mississippi about the 1999 party!! Bennett P. --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300008Date: 12/03/97 From: JIM BLISS Time: 08:07pm \/To: ALL (Read 0 times) Subj: Announcing New VIPinfoSoft Version Relea20:07:4312/03/97 From: Jim Bliss Subject: Announcing New VIPinfoSoft Version Release JBliss Imaging Systems Announces New VIPinfoSoft Version Release We are pleased to announce that Version 2.1 for both VIPinfoSoft=99 and VIPinfoSoft Plus is now released. VIPinfoSoft and VIPinfoSoft Plus Software programs are designed to be used by people with low vision or by blind people. They integrate OCR and synthetic speech technologies together with visual presentations of text to optimize the speed and ease of reading printed and electronic documents. The programs are highly adjustable for customization to the user=92s vision. VIPinfoSoft Plus adds the features of e-mail, memo editor, address book, autodial, and printing to VIPinfoSoft. Version 2.1 adds the following great new features to both VIPinfoSoft and VIPinfoSoft Plus:=20 * Books on CD: These books can be read in any of VIPinfoSoft=92s Views (i.e., Marquee, RSVP= , Word Wrap, and Image). As usual, speech can be turned on in the RSVP and Word Wrap Views. We have prepared over 600 books (e.g., including "Tale of Two Cities", "20,000 Leagues under the Sea", "Huck Finn", and "Dracula") and stored them on a single CD! This is a very exciting feature, providing a technology that revolutionizes "Talking Books"!=20 At present, only CDs that have been prepared by us are readable. We have indexed this first CD by dividing the books into sections and some sections into subsections. This makes it easy to go to a particular place in each book. There is also a "Bookmark" function so places can be saved for easy return. The purchase price of this first CD, together with the indexes on a 3.5" floppy, is $49.95. In addition, Version 2.1 has many other improvements and refinements, including a method for obtaining grade 2 braille printout from scanned and keyed-in files, the ability to save files to 3.5" floppy, and templates for specifying the sections of a page to be read and the order in which they are read. The price for VIPinfoSoft is $795 and for VIPinfoSoft Plus is $995. A demo CD, which is a full program that lasts for 30 days, is available for $25 including shipping and handling. (The $25 is deductible from the purchase price.) To order, contact JBliss Imaging Systems, 650 Saratoga Avenue, San Jose, CA 95129, toll free: 888-452-5477, 408-246-5783, e-mail: info@JBliss.com, website: http://www.JBliss.com. --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045) --------------- FIDO MESSAGE AREA==> TOPIC: 233 NFB BLIND NEWS Ref: EG300009Date: 12/03/97 From: JIM BLISS Time: 09:04pm \/To: ALL (Read 0 times) Subj: VIPinfoNet 1.1 Release From: Jim Bliss Subject: VIPinfoNet 1.1 Release JBliss Imaging Systems Announces New VIPinfoNet Version Release We are pleased to announce that Version 1.1 for our internet browser, called VIPinfoNet, is now released. This software browser is designed for people with low vision or who are blind. It converts Websites into text screens that are customized to the userAs vision (text font, colors, sizes, letter spacing and format adjusted), synthetic speech, and enlarged pictures and graphics. The new features in Version 1.1 are: * Full FTP Downloading * Access to more sites than before including sites with authorization passwords. The price for VIPinfoNet is $250 (registered owners of VIPinfoSoft get a $100 discount). A demo CD, which is a full program that lasts for 30 days, is available for $25 including shipping and handling. (The $25 is deductible from the purchase price.) To order, contact JBliss Imaging Systems, 650 Saratoga Avenue, San Jose, CA 95129, toll free: 888-452-5477, 408-246-5783, e-mail: info@JBliss.com, website: http://www.JBliss.com. --- * Origin: NFBnet <--> Internet Email Gateway (1:282/1045)