Anthem’s anesthesia time limit policy, reversal sparks new legislation

Editor's Note

Anthem Blue Cross Blue Shield recently reversed its controversial plan to impose time limits on anesthesia coverage after intense backlash from the medical community, including anesthesiologists and patient advocates. The policy, aimed at curbing alleged overbilling, would have restricted payments based on average surgery times, a move critics argued jeopardized patient safety.

In a statement criticizing the policy, the American Society of Anesthesiologists said it “revealed a diminished dedication to patient safety.” Two anesthesiologists in a Science News December 6 interview emphasized the dangers of the proposed practice, noting surgery durations vary widely based on patient complexity and unforeseen complications. “Every patient is different,” said anesthesiologist Alopi Patel, MD. “You can average out surgical times, but you can’t say…‘we’re now going to only allow’” that average time for everyone. Pediatric anesthesiologist Amy Vinson, MD, FAAP, agreed, adding that imposing time caps penalizes sicker, more complex patients and the care teams supporting them.

The outcry has inspired Rep Ritchie Torres (D-NY) to introduce the "Anesthesia For All Act," which would prohibit insurers from setting arbitrary time caps for anesthesia reimbursement, Axios December 9 reports. The legislation aims to prevent future policies that prioritize cost-cutting over patient outcomes. The bill also mandates audits to ensure compliance and accountability among insurers. “We cannot trust insurers to do right by doctors and patients out of the kindness of their hearts,” Torres stated in the article.

While Anthem claimed the policy adhered to Centers for Medicare & Medicaid Services guidelines and was intended to combat overbilling, anesthesiology groups countered that it overlooked the individualized nature of surgical care. Torres’ proposal is gaining attention amid heightened public scrutiny of healthcare policies, fueled by debates over medical costs and insurance practices.