In November, Anthem Blue Cross Blue Shield proposed a policy that would have placed time limits on procedures using anesthesia in Missouri, New York and Connecticut. After receiving pushback from patients, physicians, and industry groups, the insurer withdrew the proposal.
Similarly, Kaiser Foundation Health Plan walked back a Washington state policy that would have denied reimbursement without certain billing modifiers and reduced payments for CRNA QZ services to 85% of the physician fee schedule.
In response to these proposals, several states have moved to address anesthesia time limits through legislation. Here’s where those efforts currently stand:
Illinois:
In August, Democratic Gov. J.B. Pritzker signed a law requiring insurance companies to cover the full cost of anesthesia for the duration of a procedure. This effectively bans time limits on anesthesia reimbursements. The law took effect immediately.
New York
In May, lawmakers added a clause to both a New York State Assembly bill and a New York Senate bill that would allow health insurers to place time limits on anesthesia care. If enacted, these amendments would let insurers predetermine allowable anesthesia durations for surgeries and procedures. Both bills are currently in committee.
Washington
In February, Washington state lawmakers introduced a bipartisan bill to ban time caps on anesthesia coverage.The proposal would also authorize the Office of the Insurance Commissioner to enforce the ban through monetary penalties, license revocations or suspensions, and public disclosure of violations on its website. The bill is currently in committee
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