Anthem Blue Cross Blue Shield said Thursday the health insurance provider is reversing a policy that was set to take effect in February that would have limited anesthesia coverage during surgeries and other procedures, a change that has drawn outrage from some physicians and lawmakers. Had expressed. ,
The policy, which would have covered Anthem's plans in Connecticut, New York and Missouri, was disclosed in recent weeks, with the company's New York unit posting a Information On 1 December. The policy will not cover people below 22 years of age and maternity care.
According to the original policy statement, Anthem said it would pay for anesthesia treatment only for the period that is estimated to be needed for a procedure or surgery based on physician work time values from the Centers for Medicare and Medicaid Services. The insurer noted that “claims in excess of the established minutes for anesthesia will be denied.”
In an email to CBS News on Thursday, Anthem said it was retracting the policy, adding that there was “widespread misinformation regarding the update to our anesthesia policy.”
“As a result, 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 not be the policy of Anthem Blue Cross Blue Shield not to pay for medically necessary anesthesia services. The proposed update of the policy is only consistent with well-established clinical The guidelines were designed to clarify suitability.”
Before Anthem's reversal was announced, the plan was criticized by medical professionals as well as Connecticut Senator Chris Murphy, a Democrat, who wrote on social media on Wednesday that the plan was “appalling.”
“Patients are being burdened with staggering amounts of thousands of dollars in additional medical debt. And for what? Just to boost corporate profits?” murphy wrote“Reverse this decision immediately.”
Connecticut Comptroller Shawn Scanlon told The Hartford Courant said Thursday the policy will no longer be carried in their state after negotiations with the insurer.
“After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I am pleased to report that this policy will no longer be in effect in Connecticut,” Scanlon told the newspaper.
“The 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 no longer arbitrarily pre-determine the amount of time given for anesthesia care during a surgery or procedure,” the group said. “If an anesthesiologist submits a bill where the actual time of care exceeds Anthem's limits, Anthem will refuse payment for the anesthesiologist's care.”
The group said the insurer's new policy could result in the denial of coverage to patients who may need more anesthesia because their surgery is difficult or unusual, or if a complication occurs.
Donald E. Arnold, MD, anesthesiologist and president of the American Society of Anesthesiologists, said, “This is the latest in a long series of appalling behavior by commercial health insurers seeking to increase their profits at the expense of patients and the physicians providing essential care.” Anesthesiologist. “This egregious policy breaks the trust between Anthem and its policyholders who expect their health insurers to pay physicians for all of their care.”