Anthem Blue Cross Blue Shield to reverse plan to cap anesthesia coverage in 3 states following concerns
Insurance company Anthem Blue Cross Blue Shield said it will reverse a policy that would have resulted in coverage for anesthesia services being potentially capped in Connecticut, Missouri and New York.
The policy would have seen the insurance provider predetermine the time allowed for anesthesia care during a surgery or procedure and cover care only over that period.
"There has been significant widespread misinformation about an update to our anesthesia policy," Anthem BCBS said in a statement to ABC News. "As a result, we have decided to not proceed with this policy change. 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. The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines."
In its initial announcement last month, Anthem BCBS said it would "target the number of minutes reported for anesthesia services," adding: "Claims submitted with reported time above the established number of minutes will be denied."
Before Anthem BCBS announced the policy reversal, state officials said they had prevented the policy from going into effect in their respective states.
"After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I'm pleased to share this policy will no longer be going into effect here in Connecticut," Connecticut Comptroller Sean Scanlon wrote on X on Thursday.
Gov. Kathy Hochul sent out a statement on Thursday afternoon announcing the same for New York.
"Last night, I shared my outrage at a plan from Anthem to strip away coverage from New Yorkers who had to go under anesthesia for surgery," she said in the statement. "We pushed Anthem to reverse course and today they will be announcing a full reversal of this misguided policy. Don't mess with the health and well-being of New Yorkers -- not on my watch."
The new policy was set to go into effect beginning Feb. 1, 2025, the company had said. Anthem BCBS didn't give a reason as to why it was making this policy change.
The policy change drew sharp criticism from some health care professionals, who argued that patient care would potentially be compromised.
The American Society of Anesthesiologists (ASA) said Anthem's move was "unprecedented" and called on the insurance company to reverse the proposal immediately.
The organization argued that having a predetermined time for surgeries or procedures without considering factors -- such as a patient's health prior to surgery or preexisting conditions to determine what medical expertise is needed and how much time is needed preoperatively and postoperatively -- could result in care that is not "safe and effective."
"This is just the latest in a long line of appalling behavior by commercial health insurers looking to drive their profits up at the expense of patients and physicians providing essential care," Dr. Donald E. Arnold, president of the ASA and chair of the department of anesthesiology at Mercy Hospital in St. Louis, said in a statement.
"It's a cynical money grab by Anthem, designed to take advantage of the commitment anesthesiologists make thousands of times each day to provide their patients with expert, complete and safe anesthesia care," the statement continued. "This egregious policy breaks the trust between Anthem and its policyholders who expect their health insurer to pay physicians for the entirety of the care they need."
The ASA also penned an open letter to Elevance Health, of which Anthem is a subsidiary, expressing concern over the policy change and asking to hold a meeting with Anthem officials to discuss it.
The ASA also urged those who are concerned about the insurance company's proposal to contact their state insurance commissioner or their state legislators.
ABC News' Youri Benadjaoud contributed to this report
