Anthem Blue Cross Blue Shield said Thursday that the health insurance provider was canceling a policy set to take effect in February that would have limited coverage of anesthesia during surgeries and other procedures, a change that sparked outcry from some doctors and legislators. .
The policy, which would have covered Anthem’s projects in Connecticut, New York and Missouri, was disclosed in recent weeks, with the company’s New York division issuing a notice on December 1. The policy would have excluded people under 22 and maternity care. .
According to the original policy statement, Anthem said it would only pay for anesthesia treatments for the estimated duration of a procedure or surgery, based on physician time values from the Centers for Medicare and Medicaid Services. The insurer noted that requests for anesthesia “beyond the established number of minutes will be denied.”
In an email to CBS News on Thursday, Anthem said it was backing away from the policy and added that there had been “widespread misinformation about an update to our anesthesia policy.”
“As a result, we have decided not to make this policy change,” an Anthem spokesperson wrote in an email. “To be clear, it has never been and never will be Anthem Blue Cross Blue Shield’s policy to not pay for medically necessary anesthesia services. The proposed policy update was intended solely to clarify the well -based anesthesia, in accordance with well-established clinical guidelines.”
Before Anthem’s reversal was announced, the plan drew criticism from medical professionals as well as Connecticut Democratic Sen. Chris Murphy, who wrote on social media Wednesday that the plan was “appalling.”
“Hanging patients with thousands of dollars in surprise additional medical debt. And for what purpose? Just to increase corporate profits?” Murphy wrote. “Rescind this decision immediately.”
Connecticut Comptroller Sean Scanlon told the Hartford Courant on Thursday that the policy would not take place in his state after negotiating with the insurer.
“After hearing from people across the state about this concerning policy, my office contacted Anthem and I am happy to report that this policy will no longer be in effect here in Connecticut,” Scanlon told the newspaper.
“Appalling behavior of 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 allocated for anesthesia care during a surgery or procedure,” the group said. “If an anesthesiologist submits an invoice in which the actual duration of care is longer than Anthem’s limit, Anthem will deny payment for the anesthesiologist’s care.”
The insurer’s new policy could result in denying coverage to patients who might need more anesthesia because their surgery is difficult or unusual, or if a complication arises, 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 providing essential care,” said Donald E. Arnold, anesthesiologist and president of the American Society of Health. Anesthetists. “This egregious policy breaks the trust between Anthem and its policyholders, who expect their health insurer to pay doctors for the full care they need.”
