Brian Blaze of the Paragon Health Institute discusses strategies for reforming major federal health care programs.
Anthem Blue Cross Blue Shield has abandoned a policy change that would have revised its billing standards for anesthesia treatment and do not pay for these services after the deadline for this operation.
Anthem’s New York unit said this week in an administrative memo to health care providers that starting Feb. 1, the insurer will pay only up to the amount set by the Centers for Medicare and Medicaid Services (CMS) for anesthesia services that exceed the established time limit. The policy includes exceptions for patients under the age of 22 and for maternity benefits, while providers will have the ability to challenge claims if they disagree with reimbursement, Anthem said.
The ASA said in a report last month that Anthem’s plans in Connecticut, New York and Missouri will be affected by the changes.
Anthem Blue Cross Blue Shield has declined to implement a policy change that would have revised its billing standards for anesthesia care and waived payment for these services after a given surgery deadline. (Michael Nagle/bloomberg/Getty Images)
ASSASSINATION OF UNITEDHEALTHCARE CEO COMES AMID INSURANCE COVERAGE CONTROVERSY
Anthem Blue Cross Blue Shield said Thursday it would no longer move forward with the changes.
| Ticker | Security | The last one | A change | Change % |
|---|---|---|---|---|
| PRINCIPLE | ELEVANCE HEALTH INC. | 403.00 | +1.04 |
+0.26% |
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“There has been widespread misinformation about the update to our anesthesia policy,” the company said in a statement. “As a result, we have decided not to proceed with this change in policy. To be clear, it has never been and never will be Anthem Blue Cross Blue Shield’s policy not to pay for medically necessary anesthesia services. The proposed policy update was intended only to clarify the appropriateness of anesthesia in accordance with well-established clinical guidelines.”
Anthem Blue Cross Blue Shield said there will be exceptions for pregnant patients as well as patients under the age of 22. (Andrew Harrer/Bloomberg via Getty Images/Getty Images)
The proposed policy change comes amid heightened scrutiny health insurers and drew criticism from the American Society of Anesthesiologists (ASA), which called on Anthem — a subsidiary of Elevance Health — to reverse its decision.
Connecticut Comptroller Sean Scanlon said Thursday in a post on X that “After hearing from people across the state about this troubling policy, my office reached out to Anthem and I’m happy to share that this policy will no longer be in effect here in Connecticut.”
