Caveat Emptor. Let the Buyer Beware. In this case it’s the buyer of health insurance, and we’re not even referring to the cautions and red flags of the Affordable Care Act. We’re talking about patients getting their money’s worth for major medial coverage that should extend to something as basic as vision therapy for convergence insufficiency. Take a look at the letter above and you’ll see the latest trend that has come to our attention. Before paying for office based optometric vision therapy, the insurance carrier would like to see evidence that the patient has tried 12 weeks of home therapy. Where did that idea come from?
As my colleague Dr. Fortenbacher and I have blogged, the most scientific study ever conducted in the field of vision therapy was the CITT study. This study proved definitively that 12 weeks of home therapy is not significantly better than placebo therapy. Apparently the insurance company is saying that if home therapy alone can result in a near 40% cure rate by taking advantage of the placebo effect, why not try that first before agreeing to office-based therapy?
So consider this: What would your reaction be if you received a letter from your insurance carrier stating that before reimbursing for medication prescribed, the doctor is to first show evidence that a placebo pill was not effective?