Anthem Blue Cross Blue Shield said Thursday the health insurer is rescinding a policy that was scheduled to take effect in February that would have limited anesthesia coverage during surgeries and other procedures, a change that has some doctors and lawmakers worried strong protest.
The policy, which will cover Anthem’s plans in Connecticut, New York and Missouri, was revealed in recent weeks, with the company’s New York unit issuing a notice on Dec. 1.
According to the original policy statement, Anthem said it would only pay for anesthesia treatments estimated for the length of time required for the procedure or procedures based on the Centers for Medicare and Medicaid Services’ physician work time values. The insurance company noted that “anesthesia claims exceeding the specified number of minutes will be denied.”
In an email to CBS News on Thursday, Anthem said it was abandoning the policy, adding that there had been “widespread misinformation regarding updates to our anesthesia policy.”
“As a result, we have decided not to proceed with this policy change,” an Anthem spokesperson wrote in an email. “To be clear, Anthem Blue Cross Blue Shield has never had, and will never have, a policy of not paying for medically necessary anesthesia services. The proposed policy update is simply to clarify the appropriateness of anesthesia consistent with established clinical guidelines. .
Before Anthem’s cancellation was announced, the plan drew criticism from medical professionals as well as Sen. Chris Murphy, D-Conn., who wrote on social media on Wednesday that the plan was “appalling.”
“Accidentally leaving patients with thousands of dollars in additional medical debt. For what? Just to boost corporate profits?” Murphy wrote. “Reverse this decision immediately.”
Connecticut Comptroller Sean Scanlon told The Hartford Courant on Thursday that the policy will not be implemented in the state after negotiations with insurance companies.
“After hearing from people across the state about this related policy, my office reached out to Anthem, and I am pleased to share that this policy will no longer be in effect in Connecticut,” Scanlon told the newspaper.
‘Shocking behavior of commercial health insurance companies’
In a statement last month, the American Society of Anesthesiologists also called on Anthem to reverse the policy.
“Through this new policy, Anthem will arbitrarily predetermine the hours of anesthesia care allowed during a surgery or procedure,” the organization said. “Anthem will refuse to pay for anesthesia if the anesthesiologist submits a bill with actual hours of care that exceeds Anthem’s limits. The cost of nursing care.”
The group added that insurers’ new policies could result in denying coverage to patients who may need more anesthesia because their surgery is difficult or unusual, or they develop complications.
Donald E. Arnold, an anesthesiologist and president of the American Society of Anesthesiologists, said, “This is just an egregious set of behaviors by commercial health insurance companies trying to boost profits at the expense of patients and doctors who provide essential care. The latest one.” anesthetist. “This egregious policy destroys the trust between Anthem and its policyholders, who expect their health insurance companies to pay doctors for all the care they need.”
