Anthem Blue Cross Blue Shield said Thursday it might not make a policy change that may limit reimbursement for anesthesia in surgeries and medical procedures. The latest policy would have reimbursed doctors based on timelines set by the insurer.
Anthem BCBS, one in all the most important health insurers within the US, quietly announced the brand new reimbursement policy for last month Connecticut, latest York And Missouri from February. The policy change sparked outrage the American Society of Anesthesiologists.
At first the policy update went unnoticed, but that modified on Wednesday Shooting of UnitedHealthcare CEO Brian Thompson in New York City. The killing sparked a wave of intense criticism online concerning the US healthcare system, and Anthem BCBS's decision caused a stir within the discussion.
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In an announcement to NBC News: An Anthem BCBS spokesperson said: “There has been significant widespread misinformation regarding an update to our anesthesia policy. For this reason, we have decided not to move forward 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 update to the guideline only served to clarify the appropriateness of anesthesia in accordance with well-established clinical guidelines.”
Before the reversal, New York and Connecticut had intervened to forestall the plan from being implemented.
On Thursday, New York Gov. Kathy Hochul took credit for pushing for the reversal. Hochul had expressed her outrage at X on Wednesday.
“Last night I expressed outrage at a plan by Anthem to withdraw coverage from New Yorkers who were under anesthesia for surgery,” Hochul said in an announcement Thursday. “We pushed Anthem to reverse course, and today they will announce a complete reversal of this misguided policy.”
On Thursday, Connecticut Comptroller Sean Scanlon said Posted on X that the policy would now not be in effect within the state.
“After hearing about this policy from people across the state, my office reached out to Anthem and I am pleased to announce that this policy will no longer be in effect here in Connecticut,” Scanlon wrote.
There will likely be no set deadline for anesthesia during a surgery or procedure. Anesthesia is run for so long as the procedure lasts – a choice made by the treating physician, not the anesthesiologist.
“The problem here is that the time and duration of the operation is a function of the surgeon, not the anesthesiologist. “The anesthesiologist is actually at the mercy of the surgeon, no matter how long it takes him to perform the operation well,” he told Dr. Dhivya Srinivasa, founder and chief surgeon of the Institute for Advanced Breast Reconstruction in Los Angeles.
“In my field, I am a breast cancer reconstructive surgeon. There is a wide range of how long it will take depending on the complexity,” Srinivasa said.
On Wednesday afternoon, Anthem's BCBS spokesperson said the choice was made to “protect against potential overbilling by anesthesia providers” as a part of the corporate's “ongoing efforts to improve the affordability and accessibility of care.”
The insurance company would use “CMS physical labor time values to determine the appropriate number of minutes” for procedures, the spokesman said, referring to the Centers for Medicare and Medicaid Services.
Dr. Donald Arnold, president of the American Society of Anesthesiologists, sharply questioned how the insurer set the deadlines.
“No, it’s not part of Medicare or Medicaid,” he said. “No one else has a system like this.”
The CMS doctor working time values will be found on the CMS website.
“Medicare has some data,” Arnold said. “We don’t know the aim of the info. We don't know the origin. We don't understand how they’re calculated. We don't know anything about it except that we will find the spreadsheet and download it. “CMS hasn't answered our questions so we can understand how it was developed.”
CMS didn’t immediately reply to a request for comment.
In January, Blue Cross Blue Shield of Massachusetts began restricting the usage of anesthesia during colonoscopies reversed his decision after opposition from doctors, including the American Gastroenterological Association.
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