Anthem Blue Cross Blue Shield Reverses Decision to Put a Time Limit on Anesthesia

Healthcare

By Associated Press

Published 1 month ago on

December 10, 2024

Signage is displayed the outside of the corporate headquarters building of health insurance company Anthem in Indianapolis, Tuesday, May 14, 2019. (AP File)

Anthem Blue Cross Blue Shield canceled plans to tie anesthesia payments to procedure time after public outcry.
Critics, including the American Society for Anesthesiologists, condemned the policy as a profit-driven move compromising patient safety.
Officials in New York and Connecticut successfully intervened before the reversal, citing concerns over patient care impacts.

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One of the country’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.

American Society for Anesthesiologists Called on Anthem to Reverse

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.