A policy change that will restrict reimbursements for anesthesia during surgery and other medical procedures was announced by Anthem Blue Cross Blue Shield on Thursday. Under the new arrangement, doctors would have received reimbursement according to deadlines that the insurance imposed.
The new payment policy for Connecticut, New York, and Missouri, which will take effect in February, was discreetly disclosed last month by Anthem BCBS, one of the biggest health insurers in the United States. The American Society of Anesthesiologists was incensed over the policy change.
Following the shooting death of UnitedHealthcare CEO Brian Thompson in New York City on Wednesday, the policy amendment gained attention after first going unreported. Anthem BCBS’s decision erupted into the online hatred that the killing ignited against the U.S. health care system.
“There has been significant widespread misinformation regarding an update to our anesthesia policy,” a statement from Anthem BCBS said. We have thus chosen not to move further with this policy change.”
“To be clear, Anthem Blue Cross Blue Shield has never been and will never be the policy to not pay for medically necessary anesthesia services,” the representative continued. Only the appropriateness of anesthesia in accordance with existing clinical recommendations was intended to be clarified by the proposed policy modification.
New York and Connecticut had intervened to prevent the plan’s implementation prior to the reversal.
New York Governor Kathy Hochul claimed responsibility for the reversal on Thursday. Hochul had taken to X on Wednesday to voice her outrage.
I work as a reconstructive surgeon for breast cancer. The intricacy will determine how long it takes, according to Srinivasa.
A representative for Anthem BCBS stated Wednesday afternoon that the decision was taken as part of the company’s “continuous efforts to improve affordability and accessibility to care” and to “protect against potential anesthesia provider overbilling.”
According to the representative, Anthem would use the Centers for Medicare and Medicaid Services’ “CMS Physical Work Time values to determine the appropriate number of minutes” for treatments.
The American Society of Anesthesiologists’ president, Dr. Donald Arnold, raised serious concerns about Anthem’s methodology for setting the time restrictions.
“No,” he responded, “it’s not covered by Medicare or Medicaid.” “This is the only system of its kind.” The CMS website has the CMS Physician Work Time figures.
Arnold stated, “Medicare has some data.” “We are unaware of the data’s intended use. The origin is unknown. We have no idea how it’s determined. Other than being able to locate and download the spreadsheet, we are unaware of any of that. We would like to know how it was established, but CMS has not responded to our inquiries.
A request for comment from CMS was not immediately answered.
Blue Cross Blue Shield of Massachusetts started limiting the use of anesthesia during colonoscopies in January, but after opposition from physicians, including the American Gastroenterological Association, the company changed its mind.
