Anthem Blue Cross Blue Shield reverses decision to put a time limit on anesthesia

Hey there, time traveller!
This article was published 05/12/2024 (647 days ago), so information in it may no longer be current.

One of America’s largest health insurers reversed a change in policy Thursday after widespread outcry, saying it would not tie payments in some states to the length of time a patient went under anesthesia.

Anthem Blue Cross Blue Shield said in a statement that its decision to backpedal resulted from “significant widespread misinformation” about the policy.

“To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services,” the statement said. “The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”

Anthem Blue Cross Blue Shield would have used “physician work time values,” which is published by the Centers for Medicare and Medicaid Services, as the metric for anesthesia limits; maternity patients and patients under the age of 22 were exempt. But Dr. Jonathan Gal, economics committee chair of the American Society for Anesthesiologists, said it’s unclear how CMS derives those values.

In mid-November, the American Society for Anesthesiologists called on Anthem to “reverse the proposal immediately,” saying in a news release that the policy would have taken effect in February in New York, Connecticut and Missouri. It’s not clear how many states in total would have been affected, as notices also were posted in Virginia and Colorado.

People across the country registered their concerns and complaints on social media, and encouraged people in affected states to call their legislators. Some people noted that the policy could prevent patients from getting overcharged.

Gal said the policy change would have been unprecedented, ignored the “nuanced, unpredictable human element” of surgery and was a clear “money grab.”

“It’s incomprehensible how a health insurance company could so blatantly continue to prioritize their profits over safe patient care,” he said. “If Anthem is, in fact, rescinding the policy, we’re delighted that they came to their senses.”

Prior to Anthem’s announcement Thursday, Connecticut comptroller Sean Scanlon said the “concerning” policy wouldn’t affect the state after conversations with the insurance company. And New York Gov. Kathy Hochul said in an emailed statement Thursday that her office had also successfully intervened.

The insurance giant’s policy change came one day after the CEO of UnitedHealthcare, another major insurance company, was shot and killed in New York City.

___

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.