Anthem Blue Cross Blue Shield to reverse plan to cap anesthesia coverage in three states

By Mary Kekatosm ABCNews
December 5, 2024
 

Insurance company Anthem Blue Cross Blue Shield said it will reverse a policy that would have resulted in coverage for anesthesia services being potentially capped in Connecticut, Missouri and New York.
 
The policy would have seen the insurance provider predetermine the time allowed for anesthesia care during a surgery or procedure and cover care only over that period.
 
“There has been significant widespread misinformation about an update to our anesthesia policy,” Anthem BCBS said in a statement to ABC News. “As a result, we have decided to not proceed with this policy change. 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 update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”
 
In its initial announcement last month, Anthem BCBS said it would “target the number of minutes reported for anesthesia services,” adding: “Claims submitted with reported time above the established number of minutes will be denied.”
 
FILE – In this May 14, 2019, file photo signage on the outside of the corporate headquarters building of health insurance company Anthem is shown in Indianapolis.
AP Photo/Michael Conroy, File
 
Before Anthem BCBS announced the policy reversal, state officials said they had prevented the policy from going into effect in their respective states.
 
“After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I’m pleased to share this policy will no longer be going into effect here in Connecticut,” Connecticut Comptroller Sean Scanlon wrote on X on Thursday.
 
Gov. Kathy Hochul sent out a statement on Thursday afternoon announcing the same for New York.
 
“Last night, I shared my outrage at a plan from Anthem to strip away coverage from New Yorkers who had to go under anesthesia for surgery,” she said in the statement. “We pushed Anthem to reverse course and today they will be announcing a full reversal of this misguided policy. Don’t mess with the health and well-being of New Yorkers — not on my watch.”
 
The new policy was set to go into effect beginning Feb. 1, 2025, the company had said. Anthem BCBS didn’t give a reason as to why it was making this policy change.
 
The policy change drew sharp criticism from some health care professionals, who argued that patient care would potentially be compromised.
 
The American Society of Anesthesiologists (ASA) said Anthem’s move was…
 
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