Anthem Blue Cross Blue Shield is trying to put time limits on how long anesthesia can be used during surgeries and medical procedures in Connecticut, New York and Missouri.
The health insurer quietly announced the new reimbursement policy last month. It triggered outrage from the American Society of Anesthesiologists, but otherwise went unnoticed.
That changed Wednesday, following the shooting of UnitedHealthcare CEO Brian Thompson in New York City. The killing sparked a wave of online vitriol about the U.S. health care system, and Anthem BCBS’s decision roared into the conversation.
New York and Connecticut have already stepped in to stop the plan from going into effect.
New York Governor Kathy Hochul expressed her indignation. “Outrageous,” Hochul wrote on X on Wednesday. “I’m going to make sure New Yorkers are protected.”
On Thursday, Sean Scanlon, Connecticut’s comptroller, posted on X that the policy would no longer be going into effect in the 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,” Scanlon wrote.
Typically, there is no set time limit for anesthesia during a surgery or procedure. The anesthesia is administered for as long as the procedure takes — a decision determined by the doctor performing the procedure, rather than the anesthesiologist.
“The issue here is that the time, the length of surgery, is a function of the surgeon, not the anesthesiologist. The anesthesiologist is really at the mercy of the surgeon for however long they need to take to do the surgery well,” said Dr. Dhivya Srinivasa, the founder and chief surgeon at the Institute for Advanced Breast Reconstruction in Los Angeles.
“In my arena, I’m a breast cancer reconstructive surgeon, there is a wide range of how long it will pay based on complexity,” Srinivasa said.
In a statement, a spokesperson for Anthem BCBS said the decision was made to “safeguard against potential anesthesia provider overbilling” as a part of the company’s “continuous efforts to improve affordability and accessibility to care.”
It will be using the “CMS Physical Work Time values to determine the appropriate number of minutes” for procedures, the spokesperson said, referring to the Centers for Medicare and Medicaid Services.
Dr. Donald Arnold, the president of the American Society of Anesthesiologists, sharply questioned how the insurer determined the time limits.
“No, it’s not part of Medicare or Medicaid,” he said. “Nobody else has a system like this.”
The CMS Physician Work Time values can be found on the CMS website.
“Medicare has some data,” Arnold said. “We don’t know the purpose of the data. We don’t know the provenance. We don’t know how it’s calculated. We don’t know any of that, except we can find the spreadsheet and we can download it. CMS hasn’t answered our questions so that we can understand how it was developed.”
CMS did not immediately respond to request for comment.
Anthem Blue Cross Blue Shield wants to put time limits on anesthesia for surgeries
