UPDATE: Following outrage, Anthem has announced they are halting the plan described below. (CNN)
Anthem Blue Cross Blue Shield announced that early next year in certain states, it will "target the number of minutes reported for anesthesia services." That means they'll cut off paying for anesthesia if your surgery runs long.
"Claims submitted with reported time above the established number of minutes will only pay up to the CMS established amount," the company states outright.
The CMS is the Centers for Medicare and Medicaid Services (CMS). The organization establishes Physician Work Time values, metrics that quantify the time physicians spend on specific medical services for reimbursement and resource planning.
Fron the American Society of Anesthesiologists:
Anthem will arbitrarily pre-determine the time allowed for anesthesia care during a surgery or procedure. If an anesthesiologist submits a bill where the actual time of care is longer than Anthem's limit, Anthem will deny payment for the anesthesiologist's care. With this new policy, Anthem will not pay anesthesiologists for delivering safe and effective anesthesia care to patients who may need extra attention because their surgery is difficult, unusual or because a complication arises.
"This is just the latest in a long line of appalling behavior by commercial health insurers looking to drive their profits up at the expense of patients and physicians providing essential care," said Donald E. Arnold, M.D., FACHE, FASA. "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. This egregious policy breaks the trust between Anthem and its policyholders who expect their health insurer to pay physicians for the entirety of the care they need."
Previously:
• Dallas doctor poisoned patients' IV bags with bupivacaine, epinephrine and lidocaine, killing one and hurting 11 more
• Woman sues dentist who gave her 4 root canals, 8 crowns and 20 fillings in a single visit
