One of the country’s largest health insurers has reversed its decision to no longer pay for anesthesia care in certain states if the surgery or procedure goes beyond a particular time limit. The original move by Anthem Blue Cross Blue Shield, which would have started next year, alarmed doctors and policymakers.
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.
That would have left patients to shoulder the out-of-pocket costs, which could range from hundreds to thousands of dollars.
Yeesh sounds like a good idea to walk that back