Anthem Blue Cross and Blue Shield said it no longer plans to enact a proposed policy change that could have put time limits on coverage of anesthesia for some extended surgical or other procedures.
The insurer had proposed limiting payment for anesthesia care of surgeries or procedures that were extended beyond a designated time limit, according to the American Society of Anesthesiologists.
The policy, which would have taken effect Feb. 1, and impact plans in New York, Connecticut and Missouri, would have changed how Anthem determined billed times of claims. The company said it would use CMS Physician Work Time to "target the number of minutes reported for anesthesia services. Claims submitted with reported time above the established number of minutes will be denied."
ASA called the move "unprecedented."
"With this new policy, Anthem will arbitrarily pre-determine the time allowed for anesthesia care during a surgery or procedure. If an anesthesiologist submits a bill where the actual time of care is longer than Anthem's limit, Anthem will deny payment for the anesthesiologist’s care," ASA said.
On Thursday, Connecticut State Comptroller Sean Scanlon said the policy would not go into effect in Connecticut, NBC Connecticut reported.
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"After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I'm pleased to share this policy will no longer be going into effect here in Connecticut," Scanlon posted on X.
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Anthem shared a statement with NBC New York confirming the policy would not go into effect: “There has been significant widespread misinformation about an update to our anesthesia policy. As a result, we have decided to not proceed with this policy change. 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 proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”
New York Gov. Kathy Hochul said she shared her concerns with Anthem on Wednesday night.
“Last night, I shared my outrage at a plan from Anthem to strip away coverage from New Yorkers who had to go under anesthesia for surgery. We pushed Anthem to reverse course and today they will be announcing a full reversal of this misguided policy. Don’t mess with the health and well-being of New Yorkers — not on my watch," Hochul said.
Patients under the age of 22 years old or in maternity care would have been excluded from the policy.
