Massachusetts Gastroenterology Association Statement on BCBSMA's Pause of Restrictive Sedation Policy, Upholding Quality Patient Care

The Massachusetts Gastroenterology Association (MGA) applauds the decision by Blue Cross Blue Shield of Massachusetts (BCBSMA) to pause the implementation of Policy #154, which aimed to restrict coverage of Monitored Anesthesia Care for many patients undergoing colonoscopy and other endoscopic procedures.

Policy #154 raised significant concerns within the medical community and among patients, including increased barriers to patient care access and creating inefficiencies in existing efficient medical systems, confusion and fear among patients, and highlighted the shortage of nurses trained to provide conscious sedation.

Over the past several months, the MGA, together with the Massachusetts Medical Society,  American Society for Gastrointestinal Endoscopy, American College of Gastroenterology, American Gastroenterological Association and Digestive Health Physicians Association, have actively opposed the implementation of this policy.  Our advocacy was driven by our commitment to protecting the physician-patient relationship and maintaining the high standard of healthcare that patients in Massachusetts expect and deserve.

We are pleased that BCBSMA has officially paused the implementation of this restrictive sedation policy, and that claims denied after January 1, 2024, will be retroactively approved, ensuring continuity of care for our patients. 

We appreciate BCBSMA's openness to continued dialogue and their acknowledgment of the policy's potential impact on our medical community. The MGA will maintain an active role in working with BCBSMA to prioritize patient health in any future policy considerations.

The MGA was founded on the principles of education, networking, and advocacy. Today’s decision underscores how important it is for the Massachusetts GI community to continue to speak with one voice. We extend our heartfelt thanks to our MGA members and the entire medical community for their unwavering support and advocacy in this matter. This outcome is not just a victory for healthcare providers but also for the patients we serve, reaffirming our commitment to accessible and quality healthcare in Massachusetts.

Sincerely,

Lauren Bleich, MD MPH; MGA President