In Connecticut, New York, and Missouri, Anthem Blue Cross Blue Shield is working to limit the amount of time that anesthesia can be used for surgeries and other medical procedures.
Last month, the health insurance made a covert announcement about the new reimbursement policy. It went ignored save for the American Society of Anesthesiologists’ indignation.
That changed on Wednesday after Brian Thompson, the CEO of UnitedHealthcare, was shot in New York City.Anthem BCBS’s decision erupted into the online hatred that the deaths aroused about the U.S. health care system.
Already, Connecticut and New York have intervened to prevent the plan from being implemented.
Kathy Hochul, the governor of New York, voiced her outrage. On Xon Wednesday, Hochul wrote, “Outrageous.” I will ensure the safety of the people of New York.
The comptroller of Connecticut, Sean Scanlon, said on X on Thursday that the policy would no longer be implemented in the state.
My office contacted Anthem after receiving feedback from individuals throughout the state on this troubling policy, and I’m happy to announce that it will no longer be implemented in Connecticut, Scanlon wrote.
Generally speaking, anesthetic during a surgery or operation has no time restriction. Rather than the anesthesiologist, the doctor doing the procedure decides how long the anesthesia should be supplied.
The problem here is that the surgeon, not the anesthesiologist, determines the duration and timing of the procedure. According to Dr. Dhivya Srinivasa, the founder and chief surgeon of the Institute for Advanced Breast Reconstruction in Los Angeles, the anesthesiologist is truly at the mercy of the surgeon for however long it takes to do the procedure properly.
According to Srinivasa, there is a broad variation in the length of time it will cost depending on complexity in my field as a breast cancer reconstructive surgeon.
As part of Anthem BCBS’s ongoing efforts to increase accessibility and affordability of treatment, a spokesman said in a statement that the decision was taken to protect against possible overbilling by anesthetic providers.
According to the spokesman, the Centers for Medicare and Medicaid Services’ Physical Work Time values would be used to calculate the right number of minutes for treatments.
The American Society of Anesthesiologists’ president, Dr. Donald Arnold, raised serious concerns about the insurer’s methodology for setting the time restrictions.
“No,” he responded, “it’s not covered by Medicare or Medicaid.” This is the only system of its kind.
The CMS website has the CMS Physician Work Time figures.
According to Arnold, Medicare has some data. The purpose of the data is unknown to us. The provenance is unknown. We have no idea how it’s determined. Other than being able to locate and download the spreadsheet, we are unaware of any of that. In order for us to comprehend how it was created, CMS has not responded to our inquiries.
A request for comment was not immediately answered by CMS.
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