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An article from
Dive Brief


ELEVANCE CANCELS PLAN TO CAP ANESTHESIA COVERAGE FOR SURGERIES

The insurer’s Anthem Blue Cross Blue Shield subsidiary is pulling the
controversial policy, citing “significant widespread misinformation.”

Published Dec. 5, 2024
Rebecca Pifer Senior Reporter
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Elevance headquarters in Indianapolis, Indiana Permission granted by Elevance
Health

Elevance has scrapped a controversial plan to enact time limits on anesthesia
coverage for certain surgeries, following public outcry and opposition from
physician groups.

The policy change was slated to go into effect in February for members of Anthem
Blue Cross Blue Shield in New York, Connecticut and Missouri. The news flew
under the radar after being announced last month, but roared back into the
public sphere on Wednesday after UnitedHealthcare CEO Brian Thompson was shot
and killed in New York City. The executive’s death sparked waves of anti-health
insurer sentiment online.




“There has been significant widespread misinformation about an update to our
anesthesiology policy,” an Elevance spokesperson said in an email sent to
Healthcare Dive on Thursday. “As a result, we have decided to not proceed with
this policy change.”

The spokesperson said that “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.”

According to an Anthem provider newsletter, the insurer planned to use Physician
Work Time values set by the CMS as the basis for anesthesia coverage. Any claims
submitted for services that took longer than those set minutes would be denied.
People under 22 and maternity care would have been exempt from the policy.

The American Society of Anesthesiologists railed against the change, arguing
tying anesthesia coverage to CMS estimates of how long a service should take is
“not an accepted, reliable, or rational method for payment” in a letter to
Elevance CEO Gail Boudreaux. Elevance is the parent company of Anthem-branded
plans.

“The CMS Physician Work Time was not developed nor intended to support reporting
or payment for anesthesia services,” the ASA wrote in the letter dated November
12.

Typically, there is no set time limit on reimbursement for anesthesia. Instead,
the pain management treatment extends as long as a physician requires to perform
a surgery or other healthcare service. That’s important, as the duration of a
surgery may be extended if medical complications arise, the ASA said.



Keep up with the story. Subscribe to the Healthcare Dive free daily newsletter

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Doctors underestimate the duration of a surgery roughly one-third of the time,
according to a study published last year. As such, cutting off anesthesia
coverage at a pre-specified time could saddle patients with unexpected
out-of-pocket costs.

The policy is a “cynical money grab by Anthem,” ASA President Donald Arnold said
in a statement.

Elevance defended the policy as a safeguard against anesthesia provider
overbilling, and consistent with standard coding requirements.

The insurer’s spokesperson did not respond to questions about evidence of
overbilling in New York, Connecticut and Missouri, or what specific
misinformation was leading Anthem to revoke the policy change.

Elevance’s about-face on the policy also followed politicians in New York and
Connecticut who expressed opposition to the caps.

Insurers frequently turn to medical management practices like restrictive
coverage policies or prior authorization to combat fraud, abuse and unnecessary
healthcare spending, citing the need to curb ever-rising medical costs. However,
the companies are facing mounting criticism for allegedly using the tactics to
delay and deny medical care for their members in a bid to boost profits.

Between 2022 and 2023, care denials increased an average of 20.2% for commercial
claims and 55.7% for Medicare Advantage claims, according to American Hospital
Association data from September. Many such denials are later overturned on
appeal.


RECOMMENDED READING

 * Industry condolences, social media vitriol follow UnitedHealthcare CEO’s
   killing By Rebecca Pifer • Dec. 5, 2024

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EDITORS’ PICKS

 * Chip Somodevilla via Getty Images
   
   
   HOW THE HEALTHCARE INDUSTRY IS REACTING TO A SECOND TRUMP TERM
   
   Donald Trump’s first term as president was characterized by significant
   turbulence for government healthcare programs. Here’s how some of the most
   influential industry groups responded to the Republican’s reelection.
   
   By Rebecca Pifer • Nov. 7, 2024
 * Alex Wong / Staff via Getty Images
   
   
   CMS PROPOSES NEW GUARDRAILS ON MEDICARE ADVANTAGE PRIOR AUTHORIZATIONS,
   MARKETING
   
   The Biden administration is attempting to push through a slew of reforms to
   the controversial MA program in its final months in power, though it will
   need the Trump administration’s buy-in to get them across the finish line.
   
   By Rebecca Pifer • Nov. 27, 2024


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   AI-Powered Motio… From OneStep
 * Amar Urhekar announced as CEO of Avalere Health From Avalere Health
 * The Health Marketing Collective Wins Signal Award for Podcast Excellence From
   Inprela Communications
 * Hinge Health Partners with Amazon Health Services to Expand Access to MSK
   Care From Hinge Health

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WHAT WE’RE READING

 * The Hill Luigi Mangione may have filed insurance claim for back pain, NYPD
   says
 * The Texas Tribune Texas agency to ask for $300M for Medicaid enrollment fix
 * The Wall Street Journal Doctors Say Dealing With Health Insurers Is Only
   Getting Worse

View all


EVENTS

 * 12 DEC
   Webinar | noon ET AI in Healthcare: Revolutionizing Operations and Patient
   Care Presented by studioID and Workday
 * 24 MAR
   Conference Channel Partners Conference & Expo, co-located with MSP Summit Las
   Vegas, Nevada
   Presented by Informa

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COMPANY ANNOUNCEMENTS

View all | Post a press release
OneStep and HTS Partner to Revolutionize Fall Prevention and Senior Care with
AI-Powered Motio…
From OneStep
December 12, 2024
Amar Urhekar announced as CEO of Avalere Health
From Avalere Health
December 12, 2024
The Health Marketing Collective Wins Signal Award for Podcast Excellence
From Inprela Communications
December 03, 2024
Hinge Health Partners with Amazon Health Services to Expand Access to MSK Care
From Hinge Health
December 05, 2024
Editors’ picks
 * Chip Somodevilla via Getty Images
   
   
   HOW THE HEALTHCARE INDUSTRY IS REACTING TO A SECOND TRUMP TERM
   
   Donald Trump’s first term as president was characterized by significant
   turbulence for government healthcare programs. Here’s how some of the most
   influential industry groups responded to the Republican’s reelection.
   
   By Rebecca Pifer • Nov. 7, 2024
 * Alex Wong / Staff via Getty Images
   
   
   CMS PROPOSES NEW GUARDRAILS ON MEDICARE ADVANTAGE PRIOR AUTHORIZATIONS,
   MARKETING
   
   The Biden administration is attempting to push through a slew of reforms to
   the controversial MA program in its final months in power, though it will
   need the Trump administration’s buy-in to get them across the finish line.
   
   By Rebecca Pifer • Nov. 27, 2024

Latest in Payer
 * Democrats question Oz over Medicare Advantage advocacy, UnitedHealth stock
   By Emily Olsen
 * Consumers who delayed choosing health insurance cite concerns with Trump
   administration: survey
   By Rebecca Pifer
 * New bipartisan legislation would force insurers, PBMs to sell pharmacy
   businesses
   By Rebecca Pifer
 * FTC warns 21 healthcare marketers against deceptive claims
   By Maura Webber Sadovi

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