Major insurer causes outrage after introducing new restrictions on coverage of anesthesia
Wallingford, Connecticut - A major US health insurance provider has announced it may no longer cover anesthesia for surgeries or medical procedures that exceed a predetermined time limit – regardless of any complications that may arise.
Anthem Blue Cross Blue Shield last month revealed the change, which is to take effect in February 2025 and impact policyholders in Connecticut, New York, and Missouri. The only exceptions are for maternity care and for patients under the age of 22.
The insurer will rely on Physician Work Time Value estimates from the Centers for Medicare & Medicaid Services, but these times do not take into account individual patients' needs or complications that may arise during surgery.
Health care providers fear the new policy may result in patients waking up to massive bills after hospital treatment, in a country where medical debt already exceeds $220 billion.
The American Society of Anesthesiologists has called for a reversal of the dangerous policy.
"This is just the latest in a long line of appalling behavior by commercial health insurers looking to drive their profits up at the expense of patients and physicians providing essential care," said the group's president, Dr. Donald Arnold.
"It’s a cynical money grab by Anthem, designed to take advantage of the commitment anesthesiologists make thousands of times each day to provide their patients with expert, complete and safe anesthesia care," he continued.
"This egregious policy breaks the trust between Anthem and its policyholders who expect their health insurer to pay physicians for the entirety of the care they need."
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