Anthem Blue Cross Blue Shield said Thursday it was not going ahead with a policy change that might limit reimbursements for anesthesia during surgeries and medical procedures. The brand new policy would have reimbursed doctors based on cut-off dates set by the insurer.
Anthem BCBS, certainly one of the most important health insurers within the U.S., quietly announced the brand new reimbursement policy last month for Connecticut, Recent York and Missouri starting in February. The policy change triggered outrage from the American Society of Anesthesiologists.
Initially, the policy update went unnoticed, but that modified Wednesday, following the shooting of UnitedHealthcare CEO Brian Thompson in Recent York City. The killing sparked a wave of online vitriol in regards to the U.S. health care system, and Anthem BCBS’s decision roared into the conversation.
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In a press release to NBC News, a spokesperson for Anthem BCBS said, “There was significant widespread misinformation about an update to our anesthesia policy. Consequently, we have now decided to not proceed with this policy change.”Â
The spokesperson added, “To be clear, it never was and never shall be the policy of Anthem Blue Cross Blue Shield to not pay for medically essential anesthesia services. The proposed update to the policy was only designed to make clear the appropriateness of anesthesia consistent with well-established clinical guidelines.”
Before the reversal, Recent York and Connecticut had stepped in to stop the plan from going into effect.
On Thursday, Recent York Gov. Kathy Hochul took credit for pushing for the reversal. Hochul had expressed her indignation on X on Wednesday.
“Last night, I shared my outrage at a plan from Anthem to strip away coverage from Recent Yorkers who needed to go under anesthesia for surgery,” Hochul said in a press release Thursday. “We pushed Anthem to reverse course and today they shall be announcing a full reversal of this misguided policy. “
On Thursday, Sean Scanlon, Connecticut’s comptroller, posted on X that the policy would not be going into effect within the state.
“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 not be going into effect here in Connecticut,” Scanlon wrote.
Typically, there is no such thing as a set cut-off date for anesthesia during a surgery or procedure. The anesthesia is run for so long as the procedure takes — a choice determined by the doctor performing the procedure, relatively than the anesthesiologist.
“The difficulty here is that the time, the length of surgery, is a function of the surgeon, not the anesthesiologist. The anesthesiologist is admittedly on the mercy of the surgeon for nonetheless long they should take to do the surgery well,” said Dr. Dhivya Srinivasa, the founder and chief surgeon on the Institute for Advanced Breast Reconstruction in Los Angeles.
“In my arena, I’m a breast cancer reconstructive surgeon. There’s a wide selection of how long it should take based on complexity,” Srinivasa said.
On Wednesday afternoon, the Anthem BCBS spokesperson said the choice had been made to “safeguard against potential anesthesia provider overbilling” as a component of the corporate’s “continuous efforts to enhance affordability and accessibility to care.”
The insurance company can be using the “CMS Physical Work Time values to find out the suitable variety of minutes” for procedures, the spokesperson said, referring to the Centers for Medicare and Medicaid Services.
Dr. Donald Arnold, the president of the American Society of Anesthesiologists, sharply questioned how the insurer had determined the cut-off dates.
“No, it is not a part of Medicare or Medicaid,” he said. “No person else has a system like this.”
The CMS Physician Work Time values may be found on the CMS website.
“Medicare has some data,” Arnold said. “We do not know the aim of the info. We do not know the provenance. We do not understand how it’s calculated. We do not know any of that, except we will find the spreadsheet and we will download it. CMS hasn’t answered our questions in order that we will understand the way it was developed.”
CMS didn’t immediately reply to a request for comment.
In January, Blue Cross Blue Shield of Massachusetts began restricting using anesthesia during colonoscopies but reversed its decision after pushback from doctors, including the American Gastroenterological Association.Â
