Aetna Changes Policy on Colonoscopies

As of April 1st, Aetna Insurance will no longer cover for an anesthesiologist or anesthetist to administer a Propofol, which is a deep sedative, during a colonoscopy. In the past a patient could be heavily sedated so that they would not feel the procedure, and they would not remember it as well. According to Aetna spokesman, Walt Cherniak, he says that general sedation is cheaper and works just as well. Wouldn't we like to get him on the table?

Each year more than fifty thousand people die of colorectal cancer. Colorectal cancer is the second leading cause of death, next to lung cancer among all the cancers for men and woman. There is someone dying of colon cancer ever 9.3 seconds and yet this is preventable if one can take the proper foresight and get a colonoscopy done once you hit the age of 50; however only 53% of people over 50 have a colonoscopy done. One of the main reasons for this has been the fear of the procedure itself. And this is where Propofol came into play. Patients would be more likely to have this procedure done if they knew they would not feel or remember anything.

According to Dr. Steven Meckstroth who is with the Gastroenterology Department in Naples, Florida, he says it is the first time we are finding an insurance company trying to lower quality of care just for monetary gain. He finds it very concerning when an insurance company won't pay for the extra cost to have an anesthesiologist to provide a level of care to a patient.

Aetna says they will pay for an anesthesiologist for patients that are at risk of sedation problems during endoscopic procedures which includes pregnancy, epileptics, children under 18 and seniors over 65 according to their clinical policy guidelines.

Fifty doctors from one of Atlanta's largest gastroenterologist practices presented a letter to Aetna stating that they are no longer interested in participating with Aetna because of these policy changes. This was according to the American Medical Association.

What is all this saying to us as potential patients whether it is Aetna or any other insurance company? Should we be concern? Is this a trend that has only begun? It is telling us that greed is more important than human suffering. I would advise you to ask your insurance company what your coverage is so you are not surprised.