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Speakers GI Catches a Break: Aetna Delays Controversial Sedation Policy
Aetna has announced that it will delay its plans to institute a new policy under which the insurer would cover monitored anesthesia care only for high-risk patients, according to the company's Web site.

Aetna came under scrutiny from GI groups when it announced this policy in December; critics said the insurer was prioritizing profits over patient safety and that the policy would negatively impact colorectal screening rates. Further, critics said that Aetna’s policy, which would have restricted when the insurer covered the use of the anesthesia drug propofol, would have forced organizations performing colonoscopies to limit when patients could receive the drug. The American Gastroenterological Association posited the change would discourage patients from undergoing the procedure without the powerful sedation drug.

The policy, which had an implementation date of April 1, will now be delayed until patient-friendly alternatives that do not require the added expense of an anesthesiologist become available

“We have determined that in those few markets where monitored anesthesia care has become the routine approach to sedation, implementation of our policy on April 1 would inconvenience our members in those markets and potentially depress cancer screening rates in the short term,” says Troyen A. Brennan, MD, Aetna’s chief medical officer, in a statement.

The announcement was
lauded by the AGA: “Aetna has engaged in an exchange of information and viewpoints with our society regarding the possible public health impact of this policy,” says Joel V. Brill, MD, AGAF, chair of the AGA Institute practice management and economic committee. "We are dedicated to working with all stakeholders involved to provide clear recommendations to physicians, patients, purchasers and payers regarding the appropriate use of sedation for endoscopic procedures."

 
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