Anthem Blue Cross Blue Shield announced Thursday that the health insurer is rescinding a policy that limited anesthesia coverage for surgeries and other procedures that was scheduled to go into effect in February, a change that some doctors and This prompted a backlash from lawmakers.
The policy, which covers Anthem’s plans in Connecticut, New York and Missouri, was revealed in recent weeks, with the company’s New York division posting a notice on Dec. 1. The policy would have excluded people under 22 and maternity care. .
In its initial policy statement, Anthem said it would only pay for anesthesia care for the estimated duration of the procedure or surgery, based on the Centers for Medicare and Medicaid Services’ physician time value. “Claims for anesthesia exceeding the stated number of minutes will be denied,” the insurance company said.
Anthem said in an email to CBS News on Thursday that it was backing away from this policy, adding that “misinformation regarding the anesthesia policy update has been widely circulated.”
“As a result, we have decided not to move forward with this policy change,” an Anthem spokesperson said in an email. “To be clear, it has never been and will continue to be Anthem Blue Cross Blue Shield’s policy not to pay for medically necessary anesthesia services. The “guideline is intended solely to clarify the appropriateness of anesthesia consistent with established clinical standards”. ”
Even before Anthem’s withdrawal was announced, the plan had drawn criticism from medical experts as well as Democratic Sen. Chris Murphy of Connecticut, who tweeted on social media on Wednesday that the plan was It’s scary,” he wrote.
“Putting patients on the hook for thousands of dollars in staggering additional medical debt. And for what? Just to increase corporate profits?” Murphy wrote. “Please withdraw this decision immediately.”
Connecticut State Auditor Sean Scanlon told the Hartford Courant on Thursday that after negotiations with insurance companies, the policy will not be implemented in the state.
“My office reached out to Anthem after hearing about this policy from people across the state,” Scanlon told the newspaper. I will,” he said.
“Horrible acts by private medical insurance companies”
The American Society of Anesthesiologists also called on Anthem to rescind the policy in a statement last month.
“This new policy allows Anthem to arbitrarily predetermine the amount of time allowed for anesthesia care during surgeries and procedures,” the group said. “If an anesthesiologist submits a bill that exceeds Anthem’s limits for actual treatment time, Anthem will refuse to pay for the anesthesiologist’s treatment.”
The insurer’s new policy could deny coverage to patients whose surgeries are difficult or unusual, or who may require additional anesthesia if complications occur. the group added.
“This is just the latest in a series of horrific acts by private health insurance companies seeking to increase profits at the expense of the patients and physicians providing essential care,” said Donald Anesthesiologist and American Society President.・E. Arnold said. Anesthesiologist. “This egregious policy undermines the trust between Anthem and its policyholders, who expect their health insurance companies to pay their doctors the full cost of necessary treatment.”
