The Hawaii Medical Services Association, the largest insurer in the Aloha State, is discouraging the use of propofol during colonoscopy, recommending that GI clinics use conscious sedation in most cases.

"Per national guidelines and our policy," having an anesthesia provider put a patient fully asleep for colonoscopy "should only be used when the patient in is the high risk category," HMSA told KITV.com in a statement. The insurer has reportedly been making it difficult for patients to get advance authorization for full sedation with colonoscopy and is repeatedly denying claims after the fact.

Anesthesiologist Curt Carson, MD, tells KITV that he and other doctors have begun having patients planning to receive full sedation sign waivers and agree to pay $300 if the insurer denies the claim.

"It feels like the insurance companies are trying to make that decision for the patient and for physicians, and we just don't feel that's appropriate," says Dr. Carson in the report.

Irene Tsikitas

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