Anthem Blue Cross Blue Shield decides not to proceed with new anesthesia policy

[pnwmom]

Source: KCTV5

KANSAS CITY, Mo. (KCTV) - Anthem Insurance (Blue Cross Blue Shield) has reversed course on a new policy of capping anesthesia coverage after a certain time limit.

A company representative told KCTV5 on Thursday afternoon that it has decided not to proceed with the plan.

The health insurance giant initially had announced that the move would take effect on Feb. 1, 2025. Anthem stated that it would change how it evaluates billed time on professional claims for anesthesia services.

After the American Society of Anesthesiologists (ASA) spoke out against the policy and significant public backlash, Anthem pulled back. The company cited "widespread misinformation" as its reasoning.

ON EDIT:

Aren't the Blue Cross Blue Shield plans supposed to be nonprofit? They're behaving as though they want more profit for their shareholders.

Read more: https://www.kctv5.com/2024/12/05/anthem-blue-cross-blue-shield-decides-not-proceed-with-new-anesthesia-policy/

---

The new policy would have applied to insurance plans in Missouri, NY and CT.

[Jim__]

1. Very good news!

[gopiscrap]

2. so at least one good thing came out UHC Ceo getting shot

[wcollar]

3. Gotta say it.

Wonder if the CEO shooting had anything to do with their decision?

[4catsmom]

30. who cares

I don't want to live in a country where reform is only made at the point of a gun, but Universal healthcare isn't going to come easy to the US and will be hard to hold onto.

[RandySF]

4. Good choice.

[hlthe2b]

5. "signficant" backlash? I'd bet so overwhelminng their systems were going down & they were probably

facing employee walkouts. yeah, right...

Hey Anthem? Try getting your hospitals to sign on when they have no anesthesiologists willing to work on their surgeries.

[LetMyPeopleVote]

6. good

[questionseverything]

7. They didn't expect to get caught

In Illinois for people on Medicaid are getting charged for anesthesia for at least some procedures. My granddaughter needs her wisdom teeth cut out, Medicaid will cover it but she needs to pay the anesthesia first, so of course she can’t get it done.

It’s just another tactic to reduce procedures, deny services w/o actually denying

[pnwmom]

9. That's outrageous. I'm so sorry! nt

[mucifer]

26. Yup medicaid is mnaged by HMOs here in IL

Its a mess.

[questionseverything]

28. It's just another way to deny services

Insurance companies exist to collect premiums and deny claims

That is the entire business model in a nutshell

[tonekat]

8. Sad if this is what it takes

For Americans to get the attention of Corporate America.

But...such are the times we live in. They ignored America.

Start looking over your shoulders, pigs.

[TBF]

13. Exactly.

[Karasu]

37. Hell, if that is indeed what it takes now, the blame rests entirely with the gun worshipers for making it possible.

They don't get to blame anyone else.

[Orrex]

39. When the people are denied legall and non-violent means of effecting change

They will find other means of effecting change.

[MayReasonRule]

10. Without Recourse To Maintain Life, Liberty, And The Pursuit Of Happiness Mankind Turns To Extrajudicial Means

This, is that.

[Vinca]

11. Guess the CEO got nervous.

[TBF]

12. I'll bet. nt

[Hassin Bin Sober]

14. .

[LizBeth]

15. Ya bummer that came out day one of theirs was murder. Totally amplified what they wanted done

quietly.

[Gaugamela]

16. Timing is everything.

[AllyCat]

17. Widespread "misinformation"?

What on earth is the misinformation??

[SunSeeker]

29. They just had to throw that in, those evil lying fucks.

So Trumpian, isn't it? I'm surprised they didn't use the term "fake news."

[stollen]

18. Gee, I wonder why.

[JoseBalow]

19. Watch for them to quietly do it anyways

I don't trust a word of what these fuckers say, ever.

[ancianita]

21. Agree. They're goliath and will do whatever the hell they want.

[area51]

42. Yes, they'll do what they want,

because they bribe congress.

[calimary]

49. But the last thing they want is bad publicity.

NOBODY in ANY position of power want everybody looking over their shoulders all the time, and lots of attention on what they’re up to and HOW they’re up to it.

So that’s a VERY good strategy AND tactic to apply - liberally - to our adversaries.
Attract attention.
Shine a light.

[ancianita]

20. So give the corp 'policy' boyz a cookie.

[JoseBalow]

23. The PR department earning their pay

[paleotn]

22. Safer that way.

[Rocknation]

24. It borders on medical malpractice -- class action lawsuit, anyone?

And I sincerely hope that the recent assassination of a corporate healthcare CEO isn't what tipped in our scale in our favor.


Rocknation

[AZSkiffyGeek]

27. I think the murder is why the Anesthesiologist Advocacy group issued their statement yesterday

This feels like two shitty organizations courting public approval and neither being accurate about the new guidelines.

[pnwmom]

33. Why is the Anesthesiologist Advocacy group a "shitty organization"?

And what was not accurate about their statement?

[AZSkiffyGeek]

40. They're advocating for doctors who have screwed many friends of mine

My wife was on the operating table asking whether her anesthesiologist took our insurance, because she’s heard from other friends that anesthesiologists don’t always take insurance. He said that he did, and that was the only reason she consented.
Turns out he didn’t and we spent a year arguing with his practice over a $10k bill when he refused our insurance company’s offer. They eventually settled for a grand with us.
Had three friends with similar stories.
I don’t trust them almost as much as I don’t trust insurance companies.
And all the reporting on this was based on an alarmist press release that apparently was mischaracterizing the policy. I don’t trust organizations who take that alarmist tone with the public - there are two sides to the story and all the reporting was on one side to the point people were claiming that the anesthesiologist would have to let patients die and I saw people claiming that this was the plan for every insurance company.
And this anti-insurance company press release coincidentally came out several days after the initial announcement from BCBS, on the day everyone has pitchforks out for insurance companies?

[pnwmom]

41. That's awful -- but no one among my friends or family has reported an experience like that.

I wonder if the issue is that your wife had some Medicare Advantage or other closed system insurance plan? If you have regular Medicare, for example, that wouldn't happen.

The vast majority of hospitals take Medicare, and anesthesiologists wouldn't be able to practice there unless they did, too.

And I still don't see what was incorrect about the anesthesiologists statement. Anthem said that "misinformation" was being spread but didn't explain what the misinformation was.

The policy, which would have covered Anthem's plans in Connecticut, New York and Missouri, was disclosed in recent weeks, with the company's New York unit posting a notice on Dec. 1. The policy would have excluded people under 22 years old and maternity care.

According to the original policy statement, Anthem had said it would pay only for anesthesia treatments for the length of time that a procedure or surgery is estimated to require based on the Centers for Medicare and Medicaid Service's physician work time values. The insurer noted that claims for anesthesia "above the established number of minutes will be denied."

https://www.cbsnews.com/news/anthem-blue-cross-blue-shield-anesthesia-coverage-policy/

[AZSkiffyGeek]

46. This was with Aetna

I have a lot of problems with Aetna, but they really did fight for us in this situation. And they said these situations weren’t uncommon- I think Obama may have done work to curb the practice ( but this was post ACA when we had our situation).
To me the Anesthesiologist response came off as alarmist and extreme - but from what I’ve read the announcement was more boilerplate language than the press release made it out to be. I also kinda think this was BCBS trying to screw the patient, but to stop themselves being screwed by the doctors.
A semi- related anecdote:
I work for a cable company. About 10 years ago we were in contract negotiations with AMC over carrying the station. The wanted to raise the rates - it was at the height of Walking Dead mania. We however were seeing declining subscriptions and didn’t want to pay the additional rate. So during these negotiations, AMC stopped broadcasting Walking Dead on our cable - instead they ran a chyro saying We didn’t want to provide the programming to our customers and gave them our tech support line to complain. It got a lot of angry customers and cancelled subscriptions plus bad press. We ended up taking their rate hike. But the reality was AMC was just as guilty but they got the pr jump and were able to paint us as the villain. Everyone hates the cable company.

This press release from the Anesthesiologist advocacy group feels the same way to me. It’s pr creating an angry mob with one side of a story about how this hated industry is screwing you.

I don’t understand the insurance side of the argument and think it probably is badly thought out and written, but when the only notice of it came from a scary press release from what sounds like a PAC, I just don’t trust them either.

[pnwmom]

47. For the future, have you heard about the No Surprises Act? No one is supposed to find out

as they're going into surgery that some of the medical care won't be covered!

There has been some court action about this bill, so I'm not sure about the final status, but I found this.

https://www.cms.gov/medical-bill-rights/know-your-rights/using-insurance

[AZSkiffyGeek]

48. That's the law I heard of, thanks!

It was passed several years after our debacle. I thought it was older than it actually is!

[ALBliberal]

25. My son just had major surgery with them

Good move Anthem.

[turbinetree]

31. Isn't that nice of them ............I could have seen it now on the consent form going

forward telling the patients bring a tree branch to bite down on .................

[patphil]

32. I imagine the execution murder of the UnitedHealthCare CEO figured heavily in their decision.

We need to bring back mandatory non-profit health insurance.

[W T F]

34. I guess senior management got the message after watching the country at large react to yesterday's shooting in NYC.

[Karasu]

35. Gee. I wonder what could've POSSIBLY provoked this sudden change of heart. Because it sure as fuck wasn't done out of

any sense of decency.

[PortTack]

36. Public pressure does sometimes work!

[alarimer]

38. Why would they even admit in public that they were doing that?

Maybe they thought it was a slow news day?

I have no idea.

[Xipe Totec]

43. Ya think?!

[tonekat]

44. I imagine that the dry cleaners

for healthcare C-suite types are getting lots of requests to remove the cold sweat stains today.

[mathematic]

45. Nobody seems to care that they were trying to implement Medicare billing standards?

And the doctors said, no the way medicare bills is insufficient to ensure proper care.

And everybody here agrees with the doctors, that medicare underpays providers? Is anybody at least a bit curious why this news story is 90% anesthesiologists press release?

Huh, I thought government negotiated and paid healthcare was something that was popular around here.

[pnwmom]

52. This wasn't "government negotiated and paid healthcare."

Medicare didn't say they could only pay for anesthesia in surgery to a certain time limit -- that's what Anthem said.

[LiberalArkie]

50. One insurance company has already pulled their "About Us" page off their web site.

[Macrophylla]

51. My guess...

Some random event has prompted a moment of clarity. A random event that kicked in self preservation over financial ingratiation.

Looking to squash this trend before it really gains popularity because they don't like this trend and for good reasons.

The trend may grow due to good reasons and yes they need to live in fear.