Insurance Company Faces Backlash from Anesthesiologists
Anthem Blue Cross Blue Shield has reversed its plan to implement time limits on anesthesia coverage following sharp criticism from anesthesiologists and medical professionals. The insurance giant announced on Thursday that it would not proceed with the policy change, citing concerns over misinformation and its potential impact on patient care.
“There has been significant widespread misinformation about an update to our anesthesia policy. As a result, we have decided not to proceed with this policy change,” Anthem said in a statement. The company clarified that it has always covered medically necessary anesthesia services and intended the proposed update to align with established clinical guidelines.
The now-abandoned policy, set to take effect in February, would have denied claims for anesthesia exceeding specified time limits during surgeries. Anthem framed the move as an effort to curb overbilling and make healthcare more affordable. However, critics argued the policy demonstrated a misunderstanding of anesthesia care, which varies based on patient needs and surgical complexities.
Medical Professionals Sound the Alarm
The proposed policy drew sharp condemnation from the American Society of Anesthesiologists (ASA), a major professional group representing the field. The ASA described the plan as “unprecedented” and “egregious,” emphasizing the individualized nature of anesthesia care.
“Anesthesiologists provide personalized care, attending to patients throughout the procedure, managing unexpected complications, and ensuring safety during recovery,” the ASA stated. Critics also highlighted that Anthem’s reliance on specific time limits overlooked the variability in surgical procedures and patient conditions.
Dr. Gordon Morewood, vice chair of the ASA’s Committee on Economics, revealed that Anthem executives had not conducted audits or presented evidence of widespread overbilling issues. He criticized the policy as a cost-cutting measure that would ultimately reject legitimate claims and strain providers.
Experts stressed that modern operating rooms, equipped with detailed time stamps and electronic health records, make it nearly impossible to bill for unnecessary time. Dr. Rick van Pelt, a board-certified anesthesiologist, argued that additional time under anesthesia often ensures patient safety, particularly during complications or physiological changes like blood pressure shifts.
“This approach reflects a profound lack of understanding of the role of the anesthesiologist in providing safe, high-quality care,” van Pelt said.
Trust in Care at Risk
The controversy also highlighted the broader implications of such policies for patient trust and safety. Anesthesiologists are often the last medical professionals patients meet before surgery, and trust is critical in such vulnerable moments. Dr. Morewood, who also chairs clinical anesthesiology at Temple University, said uncertainty over insurance coverage could erode confidence and distract from important conversations about medical risks and benefits.
“To have insurance companies essentially put a timer on anesthesia care is unconscionable,” Morewood remarked. He added that the potential for rushed decisions could increase the risk of adverse outcomes.
While Anthem has dropped its proposed policy, the incident underscores ongoing tensions between insurers and healthcare providers over cost-cutting measures and their impact on patient care.
