Anthem Blue Cross Blue Shield said Thursday it will not proceed with policy changes that would limit anesthesia reimbursement during surgeries and medical procedures. The new policy will provide reimbursement to doctors based on time limits set by the insurance company.
Anthem BCBS, one of the largest health insurance companies in the United States, quietly announced a new reimbursement policy last month. connecticut, New York and missouri Starting in February. Policy change sparks outrage American Society of Anesthesiologists.
Initially, the policy update went unnoticed, but that changed Wednesday, follow UnitedHealthcare CEO Brian Thompson shot In New York City. kill Anthem BCBS’s decision sparked a wave of online criticism of the U.S. health care system.
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In a statement to NBC News, A BCBS Anthem spokesperson said, “There is widespread misinformation regarding our anesthesia policy update. Therefore, we have decided not to proceed with this policy change.”
The spokesperson added, “To be clear, it has never been, and will never be, Anthem Blue Cross Blue Shield’s policy not to pay for medically necessary anesthesia services. The proposed policy update is simply to clarify the appropriateness of anesthesia, with sound clinical guidelines.
Before the reversal, New York and Connecticut had stepped in to block the plan from taking effect.
New York Gov. Kathy Hochul was credited Thursday with pushing for the reversal. Hochul expressed her outrage on X Wednesday.
“Last night, I expressed my outrage that Anthem was canceling reporting on New Yorkers who had to undergo surgery under anesthesia,” Hochul said in a statement Thursday. “We pushed Anthem to change course, and today they will announce a complete reversal. This is a misleading policy.”
On Thursday, Connecticut Auditor General Sean Scanlon Posted on X The policy will no longer be in effect in the state.
“After hearing from people across the state about this related policy, my office contacted Anthem and I am pleased to share that this policy will no longer be in effect in Connecticut,” Scanlon wrote.
Typically, there is no set time limit for anesthesia during a surgery or procedure. Anesthesia continues as long as the surgery is performed – this is determined by the doctor performing the surgery, not the anesthesiologist.
“The issue here is that the timing and length of the surgery is the responsibility of the surgeon, not the anesthetist. The anesthesiologist really depends on the surgeon, no matter how long it takes them to perform the surgery,” he said Dhivya Srinivasa Dr. is the founder and chief surgeon of the Advanced Breast Reconstruction Institute in Los Angeles.
“In my field, I’m a breast cancer reconstructive surgeon. There are a variety of times depending on the complexity,” Srinivasa said.
On Wednesday afternoon, an Anthem BCBS spokesperson said the decision was made to “prevent potential overbilling by anesthesia providers” as part of the company’s “continuous efforts to improve affordability and access to care.”
Insurers will use “CMS physical work time values to determine the appropriate number of minutes,” a spokesperson said, referring to the Centers for Medicare and Medicaid Services.
Dr. Donald Arnold, president of the American Society of Anesthesiologists, sharply questioned how insurance companies determine time limits.
“No, it’s not part of Medicare or Medicaid,” he said. “No one has a system like this.”
CMS physician working hours values can be found in content management system website.
“Medicare has some data,” Arnold said. “We don’t know what the data is used for. We don’t know where the data comes from. We don’t know how it was calculated. We don’t know anything except that we can find the spreadsheet and download it. CMS hasn’t answered our questions yet, so we can’t Learn how it was developed.
CMS did not immediately respond to a request for comment.
In January, Blue Cross Blue Shield of Massachusetts began restricting the use of anesthesia during colonoscopies, but changed decision After objections from doctors, including American College of Gastroenterology.
