Anthem Blue Cross Blue Shield drops plan to limit anesthesia coverage
COLUMBIA, Mo. (KMIZ)
Health insurance provider Anthem Blue Cross Blue Shield has decided not to limit its payments for anesthesia when procedures go too long following pushback from public officials.
The company had considered changing how it evaluates billed time on professional claims for anesthesia services, according to a post last month on the company's website.
Anthem Blue Cross Blue Shield insurance plans in Missouri, Connecticut and New York were sent to deny claims for anesthesia procedures that exceed certain time limits. Two million Missourians are insured through Anthem, according to the company's website. Anthem Blue Cross Blue Shield is also the health insurance provider for Jefferson City employees.
An Anthem spokesperson said Thursday after stories were published online about the change that the company is no longer pursuing the limits.
"There has been significant widespread misinformation about an update to our anesthesia policy," Emily Snooks wrote in an email. "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."
State Rep. David Tyson Smith (D-Columbia) shared in a X post on Thursday morning that he planned to file new legislation following Anthem's announcement.
"Blue Cross/Blue Shield has announced a new policy in Missouri to not cover anesthesia care if surgery goes beyond a certain arbitrary time," Tyson Smith said. "This is dangerous, egregious and appalling. I’m going to file legislation to prevent Blue Cross from doing this to Missourians."
Following Anthem's announcement to rescind the policy, Tyson Smith thanked those who spoke out against the policy on his social media.
"After announcing that I would file legislation preventing Anthem from limiting their anesthesia coverage during surgery, they have backtracked from this dangerous policy. Thank you to everyone who spoke out in support. This is a victory for all Missourians!" he wrote.
After announcing that I would file legislation preventing Anthem from limiting their anesthesia coverage during surgery, they have backtracked from this dangerous policy. Thank you to everyone who spoke out in support. This is a victory for all Missourians! pic.twitter.com/6GjHMGxaK1
— David Tyson Smith (@dts4mo) December 5, 2024
The change was set to go into effect on Feb. 1, 2025.
The American Society of Anesthesiologists had said it "strongly opposed" Anthem's policy and wanted it reversed immediately. The organization discussed Anthem's "unprecedented move" in a press release on Nov. 14.
The ASA had also urged people who may be concerned about Anthem’s proposal to contact their state insurance commissioner or their state legislator.
The Missouri Society of Anesthesiologists voiced its concerns in this press release on Thursday morning, and expressed gratitude to those who spoke out against it once BCBS walked back the policy.
"The Missouri Society of Anesthesiologists is thrilled to see Anthem Blue Cross Blue Shield rescind their policy," the group wrote in an email to ABC 17 News. "The collective voice drove the result of Anthem prioritizing the well-being of Missouri patients over corporate interests by withdrawing its misguided policy to limit anesthesia payments based on an arbitrary time cap. This policy jeopardized the access to care for our patients and favored quantity over quality in the operating room."
Dr. Janette McVey, who is a part of the Missouri Society of Anesthesiologists, was happy to see BCBS not go forward with the policy.
"I am happy to see the change in course in a positive direction for patient care by doing what’s right for patients and healthcare providers," McVey wrote in an email to ABC 17 News. "As anesthesia providers we will always remain vigilant in the care of our patients clinically and ethically. I look forward to and am hopeful for continued work for constructive changes."
Dave Dillon, a spokesperson with the Missouri Hospital Association, said the policy was a "very egregious example of a much larger problem." He added that Anthem's decision focused on profit rather than patient care.
“Frustration about the broken health care system is high," Dillon said. "The real question is about which side are you on? Are you about fixing it or are you about gaming it?”
