Organized Medicine: Doctors bristle over new Aetna policy

March 21, 2008

Physicians in NJ and NY are banding together to appeal to Aetna officials, who have decided to stop reimbursing for the use of the intravenous anesthetic propofol in routine colonoscopies.

Physicians in New Jersey and New York are banding together to appeal to Aetna officials, who have decided to stop reimbursing for the use of the intravenous anesthetic propofol in routine colonoscopies, effective April 1. The insurer will, however, pay for an anesthesiologist to administer the drug to patients it considers high risk. Representatives from the group NJ Physicians, a new statewide organization for doctors, are planning to meet with Aetna officials to secure coverage for all patients, regardless of risk status. They'll likely be joined at the table by members of the national organization known as the GA Alliance, which includes gastroenterology and anesthesiology groups in New Jersey and New York.

In response, Aetna says its decision follows a GI position paper that dismissed the need for propofol in average-risk patients. Ultimately, it may take a judge to decide what's best. Stay tuned.