NAPA Supports Patient Concern with Harvard Pilgrim Anesthesia Policy

MELVILLE, N.Y., Sept. 20, 2017 -- North American Partners in Anesthesia (NAPA), one of the nation’s leading single-specialty anesthesia and perioperative management companies in the US, supports patient objections to insurer Harvard Pilgrim’s anesthesia coverage policy related to endoscopic procedures.

Harvard Pilgrim, a leading health services company that serves members in New Hampshire, throughout New England and beyond, provides coverage to more than 1.2 million members, according to its website.

In a Letter to the Editor entitled “Buyer Beware of Harvard Pilgrim” published in the New Hampshire Union Leader on August 20, 2017, the writer expressed outrage that Harvard Pilgrim now denies coverage for anesthesia during colonoscopies, offering “conscious sedation” instead. The full content of the letter is published here: http://www.unionleader.com/article/20170821/OPINION04/170829898/-1/opinion04

Unlike the vast majority of accredited healthcare providers, Harvard Pilgrim gastroenterologists are now required to perform endoscopic procedures on patients while simultaneously sedating them. This is not the accepted standard of care in the United States, and is underscored by the fact that GI fellows train to perform these procedures in concert with a qualified anesthesiologist. 

As the patient points out in her letter, this policy is at odds with the coverage routinely offered by insurance providers nationwide, including Medicare and Medicaid.  The writer questions Harvard Pilgrim’s motives, suggesting Harvard Pilgrim is focused on improving their bottom line with little regard for clinical quality, patient comfort and safety or accepted standards of care.

Under HP’s rules, patients are likely to get opioids such as fentanyl for sedation. NAPA shares the writer’s concern with the use of this drug, given the opioid crisis that exists in New Hampshire and throughout the U.S.

Anesthesia during colonoscopies is the accepted standard of care. Anesthesia provided by a qualified anesthesiologist has reduced patient anxiety, causing the number of screenings to increase, allowing providers, in turn, to catch cancers sooner.  By contrast, with conscious sedation supported by insurer Harvard Pilgrim, discomfort is greater and patients often move during their procedure.  This reduces the ability to see lesions, increases procedure time, escalates risk of trauma and prolongs patient recovery.

As the letter writer indicates, she cancelled her colonoscopy due to concerns with Harvard Pilgrim’s policy and her own comfort and safety. NAPA supports the writer’s suggestion that Harvard Pilgrim rethink its position on anesthesia during endoscopic procedures. This would ensure patients do not begin to avoid vital procedures and would bring Harvard Pilgrim’s policy in line with accepted standards of care.

About North American Partners in Anesthesia
As a clinician-led organization, North American Partners in Anesthesia (NAPA) is redefining healthcare, delivering unsurpassed excellence to its partners and patients every day. In three decades, NAPA has grown to become the nation’s leading single-specialty anesthesia and perioperative management company, serving more than one million patients annually in more than 200 healthcare facilities throughout the Northeast, Mid-Atlantic, Midwest and Southeast. For more information, visit NAPAanesthesia.com.

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