BY: Walker
Published 1 month ago
Anthem Blue Cross Blue Shield is backing off of a plan that would have placed a cap on the amount of time it covers for anesthesia used during medical procedures.
The original move by Anthem Blue Cross Blue Shield, which would have started next year, alarmed doctors and policymakers.
“There has been significant widespread misinformation about an update to our anesthesia policy. As a result, we have decided to not proceed with this policy change,” the company said in a statement to NPR on Thursday afternoon.
“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 company added. “The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”
Anthem had said that starting in February it would use metrics — known as Physician Work Time values — from the Centers for Medicare and Medicaid Services (CMS) to “target the number of minutes reported for anesthesia services.”
“Claims submitted with reported time above the established number of minutes will only pay up to the CMS established amount,” it said in a note to New York providers earlier this week.
It was not clear which states would have seen the policy rolled out first. The American Society of Anesthesiologists (ASA) said the move would have taken effect in Connecticut, New York and Missouri. And it appears a similar notice had also been issued to providers in Colorado, with a March start date. On Wednesday, officials in Connecticut announced that following conversations with Anthem, the policy will no longer take effect in the state.
Anthem said it would exempt maternity-related care and patients under the age of 22, and that providers could follow a process to dispute claims if they disagreed with a reimbursement decision.
via: NPR
