UPDATE: Blue Cross Blue Shield Reverses Anesthesia Coverage Limitations Amid Outrage

Blue Cross Blue Shield Will No Longer Cover Anesthesia For The Full Length Of Certain Surgeries In Several States

Update (Dec. 5, 2024): Per Axios, Blue Cross Blue Shield is backing off of a controversial plan to limit coverage of anesthesia, according to public officials.

Anthem Blue Cross Blue Shield recently decided to “no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes,” according to the American Society of Anesthesiologists, which opposed the decision.

The decision covered plans in Connecticut, New York and Missouri.

The insurer had based the move on surgery time metrics from the Centers for Medicare and Medicaid Services, NPR reported.

The decision was controversial at the time — but outrage erupted this week after the murder of UnitedHealthcare CEO Brian Thompson in New York City cast a spotlight on divisive insurance decisions.

Original Story (Dec. 4, 2024): In a groundbreaking decision, Anthem Blue Cross Blue Shield plans in Connecticut, New York, and Missouri have announced they will no longer cover anesthesia services if a surgery or procedure exceeds a set time limit, irrespective of the actual duration of the surgery.

Payment for anesthesia services typically accounts for various factors, including the time spent by anesthesiologists providing care before, during, and after a procedure. Under this new policy, Anthem will arbitrarily set a time limit for anesthesia care during surgeries or procedures.

If the actual time exceeds this predetermined limit, Anthem will deny payment for the anesthesiologist’s services. This policy means anesthesiologists will not be compensated for providing safe and effective care, even in cases where the surgery is complex, unusual, or involves complications that require additional attention.

The American Society of Anesthesiologists has urgently called on Anthem to reverse this proposal.

Were y’all aware of this new update?