One of the nation’s major health insurers announced on Thursday that it has decided to reverse a recent policy change that would have linked payments for anesthesia in certain states to the duration a patient remained under anesthesia.
Anthem Blue Cross Blue Shield issued a statement explaining that the reversal was prompted by a considerable amount of “significant widespread misinformation” surrounding the new policy.
The company clarified, “To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services.” The proposed amendment aimed merely to provide clarity regarding the appropriateness of anesthesia as aligned with established clinical guidelines.
Under the previous plan, Anthem intended to apply “physician work time values” from the Centers for Medicare and Medicaid Services (CMS) to establish limits on anesthesia payments, although maternity patients and children under 22 would be exempt from this rule. However, Dr. Jonathan Gal, who leads the economics committee at the American Society for Anesthesiologists, indicated that the method by which CMS determines these values is not entirely transparent.
The American Society for Anesthesiologists called for immediate action to overturn the proposed policy in mid-November, asserting that it was set to start in February across states including New York, Connecticut, and Missouri. The total number of states impacted remained uncertain, as announcements were also made in both Virginia and Colorado.
Concerns were voiced across social media platforms, where individuals urged residents in the affected regions to contact their legislators. Some remarks highlighted that this policy might inadvertently lead to inflated charges for patients.
Dr. Gal expressed that the proposed policy change would have been an unprecedented measure that disregarded the “nuanced, unpredictable human element” of surgical procedures and characterized it as a blatant effort to maximize profits.
“It’s incomprehensible how a health insurance company could so blatantly continue to prioritize their profits over safe patient care,” he stated. “If Anthem is indeed withdrawing the policy, we’re pleased they recognized the error.”
Before Anthem announced its decision to reverse course, Connecticut’s comptroller Sean Scanlon commented that the concerning policy would not apply to the state following discussions with the insurer. Likewise, New York Governor Kathy Hochul confirmed in a statement on Thursday that her office had successfully intervened.
The timing of Anthem’s announcement was notable as it occurred just a day after the CEO of UnitedHealthcare, another leading insurance provider, was tragically killed in New York City.