Health insurer reverses course on anesthesia policy after receiving backlash
Proposed policy change drew criticism from the American Society of Anesthesiologists
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Anthem Blue Cross Blue Shield backtracked on imposing a policy change that would have revised its billing standards for anesthesia treatment and not pay for those services after a set time limit for a given operation.
Anthem's New York division said this week in an administrative note to health care providers that starting on Feb. 1, the insurer will pay only up to the amount established by the Centers for Medicare and Medicaid Services (CMS) for anesthesia services that exceed the set time limit. The policy has exemptions for patients under the age of 22 and maternity care, while providers will have a process to dispute claims if they disagree with the reimbursement, Anthem said.
The American Society of Anesthesiologists (ASA) said in a post last month that Anthem's plans in Connecticut, New York and Missouri would be affected by the change.
Anthem Blue Cross Blue Shield backtracked on imposing a policy change that would have revised its billing standards for anesthesia treatment and not pay for those services after a set time limit for a given operation. (Michael Nagle/bloomberg / Getty Images)
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On Thursday, Anthem Blue Cross Blue Shield said it would no longer move forward with the change.
| Ticker | Security | Last | Change | Change % |
|---|---|---|---|---|
| ELV | ELEVANCE HEALTH INC. | 406.96 | +4.21 | +1.05% |
"There has been significant widespread misinformation about an update to our anesthesia policy," the company said in a statement. "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."
Anthem Blue Cross Blue Shield said that there would be exceptions for pregnant patients as well as patients under the age of 22. (Andrew Harrer/Bloomberg via Getty Images / Getty Images)
The proposed policy change came amid heightened scrutiny of health insurers and has drawn criticism from the ASA, which called on Anthem — a subsidiary of Elevance Health — to reverse its decision.
Connecticut State Comptroller Sean Scanlon said Thursday in a post on X, "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."
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The American Society of Anesthesiologists released a statement on the reversal by Anthem saying the group welcomes the decision but that it the initial move "reflects a larger trend among commercial health insurers to unilaterally undercut established anesthesia billing and payment norms that recognize anesthesia services and care, especially for care provided in emergency situations, to patients of extreme age and for more complex and vulnerable patients who may require additional care from an anesthesiologist."