A recent policy change by health insurer Anthem Blue Cross Blue Shield (BCBS) has sparked significant backlash from the American Society of Anesthesiologists (ASA). The ASA warns that this decision could jeopardize patient safety and impose additional financial burdens on both patients and providers.

Starting February 1, 2025, Anthem BCBS will implement a new policy that caps anesthesia coverage based on the duration of surgical procedures in Connecticut, New York, and Missouri. This change, which Anthem BCBS has justified by referencing CMS Physician Work Time values, means that patients will be responsible for out-of-pocket expenses if their surgeries exceed the predetermined time limits.

Dr. Donald E. Arnold, president of the ASA, stated that this policy is “appalling” and “egregious,” arguing that it creates a precarious situation for patients undergoing complex surgeries. By not reimbursing for the entire duration of anesthesia care, the ASA fears that this will undermine the continuity of care provided by anesthesiologists during critical procedures.

Anthem’s policy has drawn sharp criticism from various stakeholders, including Governor Kathy Hochul, who described it as “outrageous” and expressed a commitment to protect New Yorkers affected by this decision. In a letter addressed to Elevance Health Inc., the corporate parent of Anthem, Dr. Arnold outlined the ASA’s grave concerns regarding the disregard for established anesthesia time billing standards.

“With this new policy, Anthem will arbitrarily predetermine the time allowed for anesthesia care during a surgery or procedure,” Dr. Arnold explained. He emphasized that this could lead to denied payments for necessary anesthesia care needed during prolonged surgeries or those with unforeseen complications.

Dr. Arnold’s letter insists on an immediate meeting with Anthem’s officials, urging them to reconsider their stance on this crucial aspect of patient care. He concluded by stating, “The policy does not contemplate individual patient needs, which are embedded within anesthesia time, including treatment of surgical complications.”

The ASA has called for individuals concerned about this policy change to reach out to their state insurance commissioners or legislators to express their views.