The bill comes after Anthem Blue Cross Blue Shield enacted and then reversed a controversial anesthesia reimbursement policy update in 2024. The update, which would have affected anesthesia claims in New York, Connecticut and Missouri, would have introduced a new reimbursement structure based on CMS physician work time values. Claims exceeding these predetermined time limits would have been denied.
Regence and Premera, subsidiaries of Blue Cross Blue Shield, are the most common insurance providers in Washington, according to the report. The bill would immediately place a ban on any provider attempting to deny coverage or cap reimbursement based on the duration of anesthesia used during a procedure.
The bill also would create enforcement policies by the Office of the Insurance Commissioners that include monetary penalties, revocation or suspension of operating licenses and public disclosures of violations on the commissioner’s website.
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.