ROCHESTER, N.Y. (WROC) — Those with Anthem Blue Cross Blue Shield (BCBS) insurance in some states will soon have to pay out of pocket for anesthesia, should their surgeries run past a set time limit.
The cutoff would apply to patients in New York State, Missouri and Connecticut.
Officials with BCBS announced the cutoff would begin with claims processed on or after Feb. 1, 2025. According to BCBS, “We will utilize the CMS Physician Work Time values to target the number of minutes reported for anesthesia services. Claims submitted with reported time above the established number of minutes will be denied.”
There are some exemptions, including patients under the age of 22 and patients in need of maternity-related care.
On Thursday, Connecticut Comptroller Sean Scanlan posted on X (formerly Twitter) that the company was backing down in that state. “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.”
In response to the news, New York Governor Kathy Hochul wrote via X, “Outrageous. I’m going to make sure New Yorkers are protected.”
The American Society of Anesthesiologists (ASA) blasted the move in a November news release discussing Anthem’s plans.
“With this new policy, Anthem will not pay anesthesiologists for delivering safe and effective anesthesia care to patients who may need extra attention because their surgery is difficult, unusual or because a complication arises,” the group said, in part.
In a statement shared by the ASA, Dr. Donald E. Arnold called the move “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.”
“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,” Arnold added.
Nexstar’s WROC reached out to Anthem BCBS for comment but had not received a response by the time of publication.
