The plans will no longer reimburse anesthesia services when submitted without the appropriate modifiers identifying who performed the service and will be reducing QZ services rendered by certified registered nurse anesthetists to 85% of the physician fee schedule.
In a Dec. 10 statement, the American Association of Nurse Anesthesiology called on “discriminates against CRNAs based on their licensure because the policy does not affect any other anesthesia providers who offer the same services as CRNAs.”
“This new anesthesia reimbursement policy will devastate healthcare delivery as it impedes access to healthcare for patients, especially in rural and underserved areas and directly conflicts with the existing federal provider nondiscrimination law for commercial health plans,” AANA President Jan Setnor, MSN, CRNA, said in the statement.
The AANA filed a petition with a U.S. district court compelling Xavier Beccera, Secretary of Health and Human Services, to enforce the provider non-discrimination provision of the ACA against insurance companies and health plans. The non-discrimination provision was passed in 2010 to prohibit commercial payers from discriminating against providers on the basis of licensure, including setting up different reimbursement policies for those providers delivering the same high-quality healthcare services.
“We call on Kaiser and other commercial payors to reverse course on these other discriminatory policies immediately,” Ms. Setnor continued in the statement. “We also call on HHS to enforce the provider nondiscrimination provision of the ACA to protect patients’ access to care.”
The call for reversal comes after Anthem Blue Cross Blue Shield reversed its decision on a controversial anesthesia reimbursement policy update, which would have introduced a new reimbursement structure based on CMS physician work-time values.
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