Washington, D.C.- Innovative Anesthesia, LLC and Anesthesia Services Group question the accuracy of a Consumer Reports.org posting dated November 19, 2014 by Lauren Cooper regarding anesthesia for colonoscopies.
Despite assertions to the contrary, Medicare has recognized that the use of propofol administered by an anesthesia professional for colonoscopies has become the “standard of care” for endoscopy procedures. The ConsumerReports.org article is not correct.
The actual language Medicare uses is as follows:
“The Medicare statute waives the Part B deductible and coinsurance applicable to screening colonoscopy. Increasingly, anesthesia separately provided by an anesthesia professional is becoming the prevalent practice in connection with screening colonoscopies, replacing the previously prevalent practice of moderate sedation provided intravenously by the physician doing the colonoscopy. Currently, when a single physician furnishes the moderate sedation and the screening colonoscopy, payment for the colonoscopy includes both services and coinsurance is waived for the entire procedure. When anesthesia for a screening colonoscopy is provided separately by an anesthesia professional, Medicare does not waive the deductible and coinsurance associated with the anesthesia. In the CY 2015 final rule, by revising the definition of a “screening colonoscopy,” CMS is including separately provided anesthesia as part of the screening service so that the coinsurance and deductible do not apply to anesthesia for a screening colonoscopy, reducing beneficiaries’ cost-sharing obligations under Part B.”
Anesthesia will continue to be billed separately and paid for by Medicare for screening colonoscopies and not be paid for out of the Medicare deductible. The paragraph in the ConsumerReports.org concerning payment and costs misrepresents what will occur starting January 1, 2015. Additionally, the post asserts safety concerns regarding anesthesia.
More recent studies, like this one, regarding patient safety show that the health status of patients seeking a colonoscopy is better suited to the use of anesthesia. Furthermore the article asserts that the cost of colonoscopies has an additional “$600-$2000 price tag” for anesthesia.
Colonoscopies performed in independent outpatient endoscopy centers have an added cost for anesthesia of approximately $250 per procedure, nowhere near the cited amounts stated in the ConsumerReports.org post. Milliman USA has done a study to confirm this amount. It appears the ConsumerReports.org post is fostering a position taken by a group of physicians that is not the position of most responsible gastroenterologists and it is disappointing that an organization such as Consumer Reports is willing to allow such bias and misleads readers regarding the prevalent standard of care without any of the research to the contrary.
For comments or further information please contact Innovative Anesthesia, LLC.