Anthem walks back anesthesia coverage policy after backlash

Anthem Blue Cross Blue Shield has walked back a controversial policy capping the amount of time it would reimburse providers for anesthesia services.

In November, Anthem Blue Cross Blue Shield Plans in Connecticut, New York and Missouri said they would implement Physician Work Time Values set by CMS for anesthesia reimbursement. Anthem said it would not pay for anesthesia services billed beyond the minutes recommended by CMS.

The policy was set to take effect in February.

The American Society of Anesthesiologists criticized the policy, alleging the insurer would “arbitrarily pre-determine the time allowed for anesthesia care.”

“It’s 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,” Donald Arnold, MD, CEO of the association, said in a Nov. 14 statement.

Anthem faced additional scrutiny when posts about the policy went viral on X on Dec. 4, prompting lawmakers to weigh in. One post was viewed over 25 million times.

In a Dec. 4 post on X, New York Gov. Kathy Hochul called the policy “outrageous.” On Dec. 5, Ms. Hochul said Anthem BCBS agreed to reverse the policy.

“Last night, I shared my outrage at a plan from Anthem to strip away coverage from New Yorkers who had to go under anesthesia for surgery,” Ms. Hochul said in a Dec. 5 statement.  “We pushed Anthem to reverse course and today they will be announcing a full reversal of this misguided policy.”

A spokesperson for Anthem BCBS told Becker’s “widespread misinformation” about the policy led to the change in course.

“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,” a spokesperson said. “The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”

Anthem BCBS is owned by Elevance Health. The company operates BCBS affiliates in 14 states.