Aetna will continue paying for colonoscopy anesthesia -- for now

Aetna said it would at least temporarily continue to pay for anesthesiologists' services during colonoscopies, reversing course after physician outcry over the health plan's initial announcement that it no longer would do so.

Aetna had told physicians that as of April 1 it no longer would pay for the services of an anesthesiologist during endoscopy procedures such as colonoscopies, which effectively meant it would not cover cases where a patient was sedated with propofol.

At least for now, the insurer has capitulated to physicians' concerns that the new policy would discourage patients from undergoing screening colonoscopies.

In a statement released Feb. 27, Aetna said it would "delay implementation until patient-friendly alternatives -- which will not require the added expense of an anesthesiologist -- are approved by the Food and Drug Administration and available in the marketplace."

Aetna Chief Medical Officer Troyen A. Brennan, MD, MPH, said in a statement that the company considers colonoscopies and other screenings "top priorities."

One physician organization said it welcomed the decision.

"The AGA Institute commends Aetna for listening to our concerns," Joel V. Brill, MD, chair of the American Gastroenterological Assn. Institute practice management and economic committee, said in a statement.

In some areas propofol has become the standard sedation, but using it as labeled requires anesthesiologist supervision during the procedure. Some physicians say they prefer using propofol rather than the traditional combination of a narcotic and benzodiazepine because it leaves the patient's system more quickly and has more predictable effects.

But the resulting bill for separate anesthesiology services adds significantly to the cost of the procedure, Aetna argued.

The AGA countered that although propofol could be administered safely by nonanesthesiologists, it should be up to a doctor, not a health plan, to decide when that was appropriate.

Though Humana and WellPoint had adopted the same nonpayment policy in 2006 and 2007, doctors said those companies weren't enforcing their new rules.

UnitedHealthcare earlier in February "reaffirmed" its decision to continue to pay for anesthesiologists' services and propofol in colonoscopies.