By Daily Mail (U.S.) | Created at 2024-12-06 01:47:14 | Updated at 2024-12-22 11:27:19
2 weeks ago
A top insurance company has walked back its 'appalling' decision to deny lifesaving anesthesia amid widespread backlash.
Health insurance giant Anthem Blue Cross Blue Shield quietly announced in February that it would no longer cover the full amount of anesthesia if a surgery went on too long.
The announcement regained attention this week after the fatal shooting of UnitedHealthcare CEO Brian Thompson in New York City this week, which police believe was a 'targeted' attack.
BCBS had said anesthesia coverage would be based on a timeline determined by the Centers for Medicare and Medicaid Services to 'target the number of minutes reported for anesthesia services.'
The company said that if a claim is submitted where the reported time for anesthesia services exceeds that number, it would be denied.
Though patients would have been able to dispute claim denials, 'documentation to support your request will be required,' according to BCBS.
However, those under age 22 and those receiving maternity-related care would not affected, the company said.
On Thursday, BCBS announced it would scrap the policy, which was meant to be implemented in New York, Missouri, and Connecticut. It was supposed to start in the affected states in February 2025.
Anthem Blue Cross Blue Shield has walked back a controversial policy that would deny anesthesia coverage if a surgery exceeded a certain timeline. Pictured is a BCBS office in Michigan
News of the policy comes just days after UnitedHealthcare CEO Brian Thompson, pictured here, was assassinated in what police believe was a targeted attack
A BCBS spokesperson told NBC News: 'There has been significant widespread misinformation about an update to our anesthesia policy.
'As a result, we have decided to not proceed with this policy change.
'To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services.
'The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.'
The cost of anesthesia depends on the procedure type and length, but it can range from $200 to $3,500 without insurance.
Experts estimate that half of operations in the US use general anesthesia, which makes a patient fully unconscious, while the other half uses local anesthesia to numb a specific area.
According to research from the National Institutes of Health (NIH), 60,000 Americans need general anesthesia every day.
Before the policy was cancelled, physicians and lawmakers called it 'outrageous' and a 'money grab.'
The American Society of Anesthesiologists said in a press release that the 'unprecedented' move is based on an 'arbitrary limit' and that payment for anesthesia is based on several factors, 'including the exact amount of time for anesthesiologists to deliver care preoperatively, during the operation, and when transitioning the patient to the recovery unit afterwards.'
Dr Donald E Arnold, president of the ASE, said in a statement: '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.
'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.
'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.'
New York Governor Kathy Hochul wrote on X: 'Outrageous. I'm going to make sure New Yorkers are protected.'
Following the news of the policy being pushed back, Hochul wrote on the platform: 'Don't mess with the health and well-being of New Yorkers - not on my watch.'
Senator Chris Murphy of Connecticut also expressed concerns.
He said on X: 'This is appalling. Saddling patients with thousands of dollars in surprise additional medical debt. And for what? Just to boost corporate profits? Reverse this decision immediately.'
Social media users also joked about the policy.
One user posted on X: 'BYOA: Bring your own anesthesia.'
Another wrote: 'So it begins. America healthcare is about to become the hunger games.'
