One of America's largest health insurance companies will begin placing limits on the amount of time a patient will be covered for anesthesia while under the knife. This is a shocking move, which doctors call “unprecedented.”
Starting in February, Anthem Blue Cross Blue Shield, which represents policyholders in New York, Connecticut and Missouri, said patients were kept under anesthesia for longer than the prescribed amount of time for some procedures. announced that it would deny the request.
“We utilize CMS physician office hours values to target the number of minutes reported for anesthesia services. Claims submitted with reported time exceeding the prescribed number of minutes will be denied.” writes the company. press release.
“This update does not change industry standard coding requirements or American Society of Anesthesiologists (ASA) anesthesia prescriptions,” Anthem claims.
The Nov. 1 announcement comes in the wake of Wednesday's killing of UnitedHealthcare CEO Brian Thompson, as new evidence suggests the gunman may have been motivated by anti-healthcare sentiment. It is attracting new interest.
The American Society of Anesthesiologists, a nearly 120-year-old organization representing 59,000 members, immediately reverses course on insurance giants, accusing them of putting “profits before patients.” I asked.
“Anthem Blue Cross Blue Shield…no matter how long the surgery takes, if the surgery or procedure exceeds a certain deadline, we will unilaterally refuse to pay for anesthesia treatment in the future.'' ,” the group said in a statement. press release.
“With this new policy, Anthem is committed to providing safe and effective anesthesia care to patients who require special consideration due to difficult, unusual, or complicating surgeries. We don't pay doctors.”
Whereas medical services are typically billed on a per-procedure or per-appointment basis, an anesthetist's job is to bill based on the exact amount of time a patient is receiving treatment, and to pay carefully based on their exact medical needs. Adjusted, the ASA claims.
In a farewell note, the group notes that Anthem Health “reported net income of $2.3 billion, an increase of 24.12% year-over-year, and net profit margin of $2.3 billion, an increase of 24.29% year-over-year.”
The only exclusions Anthem has in its strict new policy are patients under the age of 22 or anesthesia administered during childbirth-related care.
Anthem did not immediately respond to a message from the Post seeking comment.
Anthem has about 6 million members in the region, including 4.8 million in New York and 1.1 million in Connecticut, according to the company's website.
