Anthem Blue Cross Blue Shield’s decision to cap anesthesia costs based on arbitrary time limits sparked outrage among medical professionals who think it is “a cynical money grab” that prioritizes profits over patient safety.

In November 2024, the American Society of Anesthesiologists (ASA) sounded the alarm about Anthem’s new policy requiring that anesthesia services be covered only for predetermined time periods. The complexity or duration of the operation is not taken into account ASA reported.

Anthem cited concerns about overbilling and claimed the move was in line with federal guidelines.

On the other hand, critics argue that the decision is profit-oriented and carries the risk of patients incurring unexpected out-of-pocket costs.

“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, MD, FACHE, FASA. “It is a cynical cash grab by Anthem designed to exploit the commitment that anesthesiologists make thousands of times every day to provide expert, complete and safe anesthesia care to their patients. This egregious policy breaks the trust between Anthem and its policyholders, who expect this.” Health insurance must pay doctors for all the care they require.

According to Fox 61, this directive follows Anthem’s reported $2.3 billion net income increase in June 2024.

Medical professionals and lawmakers are calling for immediate action to reverse the policy. Dr. Kenneth Stone, a Connecticut anesthesiologist, criticized Anthem for undermining patient care, noting that surgery times are often prolonged due to unforeseen complications such as blood loss or complex anatomy.

Still, Anthem has defended the policy as a way to “protect against overbilling” and offered a review process for claims that exceed the limit.

However, patients and doctors remain concerned about financial uncertainty and declining trust in insurers.

The policy is scheduled to take effect in February 2025, with exceptions for maternity and child cases and Connecticut providers.

If implemented, the policy could result in increased financial burdens for patients and undermine confidence in Anthem’s coverage.