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In the News 2-02-11

Now you don’t see it… now you do.

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The FDA has approved a technological first to combat the leading cause of blindness in elderly people: a tiny telescope implanted in one eye.

Nearly 2 million Americans have advanced macular degeneration, an incurable eye disease with no apparent cause. The tiny telescope is designed specifically for people with this disease. The IMT (Implantable Miniature Telescope) is aimed at helping people in the end stages of the disease. The disease is essentially a loss of central vision that blocks reading, watching television, eventually progressing to not even being able to see faces.

The IMT works like this: Implant one eye for better central vision, the other eye will be for peripheral vision, and then the brain must fuse the two views together so as to create a single image.

There are a few requirements for having the implant issued by the FDA:

The patient must be part of the nearly 2 million people who have advanced macular degeneration

Patients and their surgeons must sign a detailed “acceptance of risk agreement” before surgery, which acknowledges potential side-effects, such as corneal damage and worsened vision.

The patient must go through highly extensive testing to determine if they are a potential candidate.

A (219 patient) study conducted by the FDA showed that almost 90% of patients that underwent the procedure and 75% of patients went from severe to moderate vision impairment.

The procedure will not let you see like you did when you were twenty, but it can make it so that if you can’t see a person’s face, now you can see everything but their nose, for example.

The device costs $15,000, and VisionCare (based in Saratoga, California) is seeking Medicare coverage for the surgery and rehab costs.


Getting disability checks for a bad back? Got a Facebook account? Better not post those horseback riding pictures…

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Employers, college admissions officers and divorce lawyers can do background checks. Police have caught fugitives. Lawyers have discredited witnesses. Companies have discovered applicants with awesome resumes participating in embarrassing – or sometimes even illegal – behavior. What’s the newest way to do this? By checking out social media sites like Facebook or MySpace.

And now insurance companies have gotten in on the act.

Such sites have become the latest way to detect insurance fraud. The industry says that fraud accounts for $80 billion a year, and 3 – 10 percent of total annual health care spending. Thus, using the same tools that have helped employers “bust” a bad employee for illicit behavior are now being used to “bust” someone who is receiving disability illegally. Or so they say.

Nathalie Blanchard from Quebec Canada, began receiving monthly insurance benefit checks when she took a medical leave from her job as an IBM technician. A year later – with no notification – they just stopped coming.

Manulife, her insurance company, terminated her benefits after viewing pictures of Natalie having fun at her own birthday party, contradicting her claim of depression. The company decided that “people diagnosed with depression are incapable of having fun for even short periods of time” and pulled Blanchard’s benefits with no notice. When she called to ask why her checks had stopped coming, Manulife said she appeared to be “available to work”, according to what they had found on her Facebook page.

Blanchard then in turn sued Manulife, accusing the company of terminating her benefits without notification and not even talking to her doctor. Manulife declined to comment on the case, but said in a statement: “We would not deny or terminate a valid claim solely based on information published on websites such as Facebook.”

Apparently there’s no real need for investigators to use a camera anymore to catch “suspects”; all they have to do is sit at their desk, follow the social networking trails, and have the “proof” photos right at their fingertips. Many experts agree, however, that the evidence gathered at the social media sites should be used as a beginning of an investigation and never the final proof of supposed fraud.

Lawyer John Beals of Piering Law Firm in Sacramento, Calif., Insurance says that companies will “bring up anything — photos of you drinking to prove that you have bad character,” he said. “Even if it’s unrelated, just the impression that you are doing something wrong can sink a case.”

One scary thought: Manulife did confirm that it does use social networking sites to investigate clients. However Blanchard has a very locked-down profile: she “keeps it private to the world at large and only allows individually approved friends” to see the things she posts.

So how did Manulife get the photos?

Social networking is all about image. I don’t think a person with, say, a bad back would post all kinds of pictures of laying in bed or a couch with signs of excruciating pain on their face.

For insurance companies to research a client’s behavior on the internet and cut off benefits when they have nothing else to go by is assuming a lot about a person. And you know what they say about the word assume…

Have an awesome week!

~ Lori Cline