Health insurance cancels the course of anesthesia policy after experiencing a relapse
Brian Blase of the Paragon Health Institute discusses strategies for reforming large federal health care systems.
Anthem Blue Cross Blue Shield backed away from putting in place a policy change that would have revised its payment standards for neurosurgery and not pay for those services after a certain time limit for a given surgery.
The New York division of Anthem said this week in an administrative letter to health care providers that starting February 1, the insurer will only pay the amount established by the Centers for Medicare and Medicaid Services (CMS) for anesthesia services that exceed the set. time limit. The policy is exempt for patients under 22 and for maternity care, while providers will have a process to dispute claims if they disagree with reimbursement, Anthem said.
The ASA wrote last month that Anthem’s programs in Connecticut, New York and Missouri would be affected by the change.
Anthem Blue Cross Blue Shield backed away from putting in place a policy change that would have revised its payment standards for neurosurgery and not pay for those services after a certain time limit for a given surgery. (Michael Nagle/bloomberg/Getty Images)
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On Thursday, Anthem Blue Cross Blue Shield said it would not move forward with the change.
| A ticker | Security | Finally | Change | Change % |
|---|---|---|---|---|
| The ELV | Company ELEVANCE HEALTH INC. | 410.39 | +3,43 |
+0.84% |
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“There has been widespread misinformation regarding the revision of our anesthesia policy,” the company said in a statement. “As a result, we have decided not to proceed with this policy change. To be clear, it has never been and never will be Anthem Blue Cross Blue Shield’s policy to not pay for medically necessary services. The proposed policy revision was designed only to clarify the appropriateness of anesthesia in accordance with well-established clinical guidelines.”
Anthem Blue Cross Blue Shield said it will exclude pregnant patients as well as patients under the age of 22. (Andrew Harrer/Bloomberg via Getty Images/Getty Images)
The proposed policy change came amid high scrutiny from health insurers and has drawn criticism from the American Society of Anesthesiologists (ASA), which has asked Anthem – a subsidiary of Elevance Health – to reverse its decision.
Connecticut State Administrator Sean Scanlon said Thursday in a post to X that, “After hearing from people across the state about this policy, my office reached out to Anthem, and I’m happy to share that this policy will no longer apply here in Connecticut.”
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