Anthem Blue Cross says it is reversing a policy restricting anesthesia coverage

Anthem Blue Cross says it is reversing a policy restricting anesthesia coverage

Anthem Blue Cross Blue Shield said Thursday that the health insurer is reversing a policy that was set to take effect in February that limited anesthesia coverage for surgeries and other procedures, a change that had sparked outrage among some doctors and lawmakers.

The policy, which would have covered Anthem’s plans in Connecticut, New York and Missouri, was announced in recent weeks, with the company’s New York office releasing a notice on Dec. 1. The policy would have excluded those under 22 and maternity care.

According to the original policy statement, Anthem had stated that it would only pay for anesthesia treatments for the amount of time a procedure or operation was estimated to require based on the Centers for Medicare and Medicaid Service physicians’ work time values. The insurer noted that claims for anesthesia will be denied “beyond the specified number of minutes.”

In an email to CBS News on Thursday, Anthem said it was withdrawing from the policy, adding that there had been “widespread misinformation regarding an update to our anesthesia policy.”

“For this reason, we have decided not to move forward with this policy change,” an Anthem spokesperson wrote in an email. “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 announcement of Anthem’s withdrawal, the plan had drawn criticism from both medical professionals and Connecticut Sen. Chris Murphy, a Democrat, who wrote on social media Wednesday that the plan was “horrific.”

“Saddening patients with thousands of dollars of unexpected additional medical debt. And for what? “Just to increase corporate profits?” Murphy wrote. “Reverse this decision immediately.”


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Connecticut Comptroller Sean Scanlon told the Hartford Courant on Thursday that the policy would not be written in his state after negotiations with the insurer.

“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 told the newspaper.

“Appalling behavior by commercial health insurers”

In a statement last month, the American Society of Anesthesiologists also called on Anthem to reverse the policy.

“With this new policy, Anthem will arbitrarily predetermine the time allowed for anesthesia care during a surgery or procedure,” the group said. “If an anesthesiologist submits a bill where the actual treatment time is longer than the time specified by Anthem, Anthem will deny payment for the anesthesiologist’s care.”

The insurer’s new policy could result in denying coverage to patients who may need more anesthesia because their surgery is difficult or unusual, or if a complication occurs, the group added.

“This is just the latest in a long line of appalling behavior by commercial health insurers seeking to increase their profits at the expense of patients and physicians who provide primary care,” said Donald E. Arnold, an anesthesiologist and president of the American Society of Anesthesiologists. “This outrageous policy breaks the trust between Anthem and its policyholders, who expect their health insurers to pay doctors for all the care they need.”

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