Mr. Torres, a potential New York gubernatorial candidate, has introduced a four-page bill called the “Anesthesia For All Act.” The legislation would prohibit time caps and direct the Department of Health and Human Services inspector general to conduct audits to ensure payers are complying.
“We cannot trust insurers to do right by doctors and patients out of the kindness of their hearts,” Mr. Torres said in a statement. “There is a need for legislation that prevents any insurer anywhere in America from micromanaging the length of anesthesia care in a medically necessary surgery.”
Anthem BCBS’ update would have introduced a new reimbursement structure based on CMS physician work time values. Claims exceeding these predetermined time limits would have been denied. Initially announced on Nov. 1, the policy would have taken effect on Feb. 1, 2025, impacting anesthesia claims across Connecticut, New York and Missouri.
The payer told Becker’s in a statement that the reversal was spurred from “widespread misinformation” surrounding the update.
“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,” Anthem’s statement continued. “The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.