An advocate of colonoscopy screening to prevent colorectal cancer, PCC not only supports efforts to increase the incidence of this Gold Standard in screening, but also vocalizes its concerns on issues that may threaten the quality and effectiveness of this life-saving procedure. While colorectal cancer is the second leading cause of cancer deaths in the United States, it is also one of the most preventable forms of the disease. Unfortunately, under new health insurance reforms, colorectal cancer screening colonoscopies are covered in full by insurers, but patients may denied anesthesia coverage for this procedure.
Troubled by the number of insurance providers with policies that restrict anesthesia services for routine gastrointestinal endoscopy, PCC has communicated its concern with insurers.
“A colorectal cancer screening colonoscopy is the Gold Standard of care for preventing this deadly disease,” says Randall Madry, PCC executive director. “This procedure can identify and remove potentially cancerous polyps in the colon before they may develop into cancer. No other screening activity prevents colorectal cancer, they only tell you when you have already developed the dreaded disease.” When caught early, colorectal cancer is 91% curable. When caught late, it is 97% fatal. When prevented, it never happens.
Less than one-half of age-appropriate people get their colonoscopy – mostly out of fear of discomfort. PCC believes insurance companies that refuse to pay for anesthesia for this procedure only encourage that fear.
Most leading experts now agree an important adjunct to a traditional colonoscopy is offering the anesthetic option of propofol during the screening procedure. Among other benefits, studies have shown a higher detection rate of precancerous polyps using propofol when compared to traditional sedation methods.
“The inconsistent interpretation by health plans about whether propofol is a covered benefit must be resolved with a consistent and clear clinical policy,” Madry says. “It is simply the right thing to do.”
The administration of propofol to patients undergoing colorectal cancer screening colonoscopies is the Gold Standard in most of the nation, but some insurance payors think that they know better than the attending physician or anesthesia provider and are refusing to pay for the service.
Please embrace the mindset that together we can make ongoing impacts in preserving the Gold Standard of care by campaigning for transparency in reimbursement methodologies, and fighting for the coverage of anesthesia during colonoscopies.