Anthem Blue Cross Blue Shield announced on Thursday that it would not proceed with a policy change that aimed to limit reimbursements for anesthesia during surgeries and medical procedures. The proposed new policy would have based doctor reimbursements on time limits set by the insurer.
The insurer, one of the largest in the U.S., had quietly introduced the new reimbursement policy last month for Connecticut, New York, and Missouri, starting in February. This move sparked outrage from the American Society of Anesthesiologists.
The policy update initially went unnoticed but gained attention following the shooting of UnitedHealthcare CEO Brian Thompson in New York City. This incident led to widespread online criticism of the U.S. healthcare system, bringing Anthem BCBS’s decision into the spotlight.
Anthem BCBS clarified in a statement to NBC News that they had decided not to proceed with the policy change due to significant misinformation surrounding it. The insurer emphasized that it was never their intention to deny payment for medically necessary anesthesia services and that the proposed policy update was meant to align with established clinical guidelines.
Before the reversal, New York and Connecticut had intervened to prevent the implementation of the plan. New York Governor Kathy Hochul claimed credit for pushing for the reversal, expressing her outrage at the initial policy.
Connecticut’s comptroller, Sean Scanlon, also confirmed that the policy would no longer be implemented in the state after receiving feedback from concerned individuals.
Anesthesia duration during surgeries or procedures typically depends on the procedure’s length, determined by the performing doctor rather than the anesthesiologist. The decision to reverse the policy was made to prevent potential overbilling by anesthesia providers and improve care affordability and accessibility.
Dr. Donald Arnold, president of the American Society of Anesthesiologists, questioned how Anthem BCBS had established the time limits, noting that the CMS Physical Work Time values were used for this purpose. The Centers for Medicare and Medicaid Services (CMS) data was referenced for determining the appropriate procedure times.
In January, Blue Cross Blue Shield of Massachusetts had also attempted to restrict anesthesia use during colonoscopies but later reversed the decision following opposition from medical professionals, including the American Gastroenterological Association.
