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Coalition Sends Letter to State Officials Demanding Consumer Protection

Against Aetna's Propofol Decision

NEW YORK, Feb. 14 /PRNewswire/ -- Aetna Inc.'s decision to greatly curtail the use of Propofol, the "gold standard" anesthesia agent available to patients during cancer screening colonoscopies, is causing a growing national outcry amongst physicians, their associations and consumers. Today, the Gastroenterologists and Anesthesiologist Alliance (GA Alliance) welcomed the Georgia Gastroenterology Society to a growing coalition that is confronting Aetna's decision.

"It is our hope that our participation in this growing alliance will allow us to effectuate change of this misdirected policy through a meeting with Aetna's executive leadership," said Dr. Indran Kirshnan, past President and Member of the Board of Governors of the Georgia Gastroenterology Society. "We will seek to enlist every patient, every potential patient, every lawmaker, every commentator, and every cancer survivor who now needs to think about their next colonoscopy without Propofol thanks to Aetna."

What was once a New York state campaign, has grown into a national campaign to expose Aetna for making a decision based on what is best for its own bottom dollar and its corporate executives over the detailed judgments made by a physician caring for a patient. To confront Aetna, the GA Alliance sent a letter to elected officials in the five states it currently represents (New York, New Jersey, Georgia, Virginia and, Delaware) calling for a state- by-state regulatory and legislative review of Aetna's action which interferes with appropriate medical practice. By the end of the week all states will be notified.

Scott Einiger, lead counsel for the GA Alliance, this week has written to all governors and state attorney generals, explaining, "We hope that your state and your leadership will carefully investigate this important healthcare and consumer issue, and take appropriate action to protect the millions of consumers affected by Aetna's proposed limitation on access to monitored anesthetic care. Our alliance asks that you carefully investigate this important healthcare and consumer issue and take the appropriate action to protect the millions of consumers affected by Aetna's proposed limitation on access to monitored anesthetic care."

Rising to the Threat

Fortunately, some states legislators are now pushing back against Aetna and its corporate executives.

The coalition welcomed Delaware Governor Ruth Ann Minner's action this week when she was joined by Delaware's insurance commissioner Matt Denn and others to decry Aetna's action.

"We applaud the recent statements of Delaware Governor Ruth Ann Minner, who decried Aetna's planned actions. Governor Minner has announced that she will not allow Delaware state employees to be affected by Aetna's wrongful actions," Einiger said in the letter. "In this, an election year, it is critical that our political leadership -- both Democratic and Republican -- not be deterred by an organization with resources such as Aetna, which reported an income of $450 Million for the recent fiscal quarter and almost $2 Billion for previous years, all while raising premiums 14 percent."

Consumer Fraud, Patient Pain

Scott Einiger, a partner with the law firm of Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP, and representing the alliance, stated, "As Aetna has failed to provide notification to its 16.4 million enrolled members, seeking to get the media to do its job by issuing a press statement about its policy change on the eve of the December holidays, it is obvious that the insurance carrier is attempting to duck regulatory scrutiny of their actions."

Einiger warns that Aetna may be facing charges of consumer fraud in many of the states where they do business. "Consumers have the right to expect that their insurance policies (either paid for or earned through employment benefits) should provide the same level of coverage as when it began. Aetna should not "bait and switch" its members in the middle of their coverage. Doing so, only forces consumers to accept lesser coverage-one that clearly promotes substandard care. Clearly, Aetna received approval from state insurance departments and other state regulatory agencies to offer health insurance coverage to the public. We fear and expect a consumer fraud and healthcare crisis will be perpetrated on Americans across the country, if Aetna's policy is implemented."

Background on Propofol and Cancer

Colon and rectal cancers trail only lung and prostate cancer as the number one cause of cancer death among Americans, according to the Federal Centers for Disease Control. This year an estimated 147,000 Americans will be diagnosed with colorectal cancer and 56,500 will die from this disease, with an approximate 1-in-18-lifetime probability of developing colorectal cancer. Currently, only 37 percent of cases are diagnosed when the disease is still localized.

Despite the fact that hundreds of thousands of Americans are diagnosed with colon and rectal cancer each year, Aetna unsuccessfully attempted to change its policy on paying for certain anesthesia in May 2006. Immediately after, Propofol was accepted by Aetna as a recognized "gold standard" and the proper and best anesthetic to use for endoscopic procedures. And now, while other insurers continue to cover the use of Propofol, Aetna seeks to place its corporate interests ahead of its 16.6 million members.

The GA Alliance includes the New York Count Medical Society, New York Society for Gastrointestinal Endoscopy, New Jersey State Society of Anesthesiologists, New Jersey Gastroenterology and Endoscopy Society and the Georgia Gastroenterology Society, as well as individual physicians practicing gastroenterology and anesthesiology from across the country. They are collaborating with other organizations throughout the medical community across America to effectuate change in Aetna's policy.

SOURCE Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato&
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