Anthem Blue Cross Blue Shield faced backlash for its proposed anesthesia policy that would limit coverage in certain situations. The policy, which was set to take effect in three states, drew criticism from anesthesiologists and patients.
The controversy arose from the insurer's plan to restrict payment for anesthesia services based on the duration of surgical procedures. The American Society of Anesthesiologists (ASA) argued that this policy would create barriers to patient care and undermine established clinical practices. Anthem intended to apply time limits based on CMS Physician Work Time values, but the ASA criticized this approach, stating that it could lead to incorrect clinical timekeeping.
Patients also expressed concern over potential medical debt. State officials, including Connecticut Comptroller Sean Scanlon and Attorney General William Tong, opposed the policy, emphasizing the need for insurance policies to align with medical standards. The ASA's engagement with Anthem raised concerns about the insurer's willingness to collaborate with medical professionals.
Anthem clarified that the policy was intended to provide clarity on the appropriateness of anesthesia services but reversed it due to the backlash. The incident raises questions about the balance between cost management and patient care. The ASA's concerns highlight the complexities of insurance reimbursement models.
The recent events serve as a reminder of the ongoing tensions between healthcare providers, insurers, and patients, emphasizing the need for transparent and fair insurance practices.