Anthem Blue Cross Blue Shield will not proceed with policy change

ALBANY, N.Y. (NEWS10)--- From ACL surgery to Quadruple bypass, anesthesia is a critical for patients. "No one, no patient wants to be under anesthesia any longer that is medically necessary," said Assemblyman David Weprin, Assembly Chair of the Insurance Committee. "That’s a decision that should be made by doctors, not by insurance companies." Anthem Blue [...]

Dec 5, 2024 - 23:08
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Anthem Blue Cross Blue Shield will not proceed with policy change

ALBANY, N.Y. (NEWS10)--- From ACL surgery to Quadruple bypass, anesthesia is a critical for patients.

"No one, no patient wants to be under anesthesia any longer that is medically necessary," said Assemblyman David Weprin, Assembly Chair of the Insurance Committee. "That’s a decision that should be made by doctors, not by insurance companies."

Anthem Blue Cross Blue Shield planned to put a limit on anesthesia coverage for some surgeries, meaning New Yorkers would need to pay for the remainder of the cost if their surgery went over a time frame. 

https://providernews.anthem.com/new-york/articles/anesthesia-billed-time-units-commercial-22477

The American Society of Anesthesiologists released a letter calling on Anthem to reverse the move— noting it will also impact people in Connecticut and Missouri.

https://www.asahq.org/about-asa/newsroom/news-releases/2024/11/anthem-blue-cross-blue-shield-will-not-pay-complete-duration-of-anesthesia-for-surgical-procedures

New York State leaders voiced their opposition as well.

In a statement, Anthem Blue Cross Blue Shield said it would not proceed with its policy change adding, “It was never the policy to not pay for medically necessary anesthesia services. The proposed the update to the policy was only design to clarify the appropriateness of anesthesia rather consistent with well-established clinical guidelines.”

Despite the reversal, Senator Michael Gianaris spoke about future legislation.

"When we go back into session in January, it wouldn’t hurt even if they end up not implementing this, to establish the rules in New York to make sure Anesthesia coverage is provided for people and there is not a time limit set on it," said Senator Gianaris, Deputy Leader of the New York State Senate. "Nobody wants to be on the operating table longer than they have to be, and I don’t think doctors want to keep people on the operating table longer than they need to be."

According to Connecticut's state comptroller, the policy will no longer be going to in effect in his state as well.

https://twitter.com/CTComptroller/status/1864711481796788270

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