Anthem Blue Cross Blue Shield has backed off a plan to restrict how anesthesiologists are paid amid an uproar from a trade group.
The change, proposed for Connecticut, New York and Missouri, would have restructured how anesthesiologists can be charged for their work in surgeries to work more like Medicare reimbursements; they would only be paid for a certain amount of time, and if the surgery ran longer — possibly due to complications — that would not be billable.
The American Society of Anesthesiologists responded with a furious press release attacking the decision.
"Anesthesiologists provide individualized care to every patient, carefully assessing the patient’s health prior to the surgery, looking at existing diseases and medical conditions to determine the resources and medical expertise needed, attending to the patient during the entire procedure, resolving unexpected complications that may arise and/or extend the duration of the surgery, and working to ensure that the patient is comfortable during recovery."
The American Society of Anesthesiologists claimed the policy would result in the insurer no longer paying for "anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes."
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Social media erupted over the policy, as did some insurance regulators in the affected states, amid fears that this would lead to arbitrary denials of claims for people having surgeries. However, this would unlikely have occurred; it would simply cap how much anesthesiologists could bill for past a certain time.
In the past, it was common practice for anesthesiologists — who are among the highest-paid medical specialists in the United States — to bill patients for the difference when insurers do this, a practice called "balance billing" or more derisively, "surprise billing." This was especially common when the anesthesiologist was not in the patient's insurance network, even when the hospital and surgeon were, something that many patients didn't even know until getting sprung with thousands in expenses. However, the recently passed No Surprises Act sharply restricted the practice.
Regardless, amid the outcry, Anthem Blue Cross Blue Shield reversed their decision in an announcement seeking to clarify the only purpose of the policy was to set a more consistent standard for how doctors are paid, Axios reported.
Some commenters on social media speculated the decision might have come in part as a result of this week's shocking murder of UnitedHealth's CEO in New York City.
