Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News Editorials & Other Articles General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search

pnwmom

(109,763 posts)
Thu Dec 5, 2024, 05:23 PM Dec 2024

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

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.
52 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
Anthem Blue Cross Blue Shield decides not to proceed with new anesthesia policy (Original Post) pnwmom Dec 2024 OP
Very good news! Jim__ Dec 2024 #1
so at least one good thing came out UHC Ceo getting shot gopiscrap Dec 2024 #2
Gotta say it. wcollar Dec 2024 #3
who cares 4catsmom Dec 2024 #30
Good choice. RandySF Dec 2024 #4
"signficant" backlash? I'd bet so overwhelminng their systems were going down & they were probably hlthe2b Dec 2024 #5
good LetMyPeopleVote Dec 2024 #6
They didn't expect to get caught questionseverything Dec 2024 #7
That's outrageous. I'm so sorry! nt pnwmom Dec 2024 #9
Yup medicaid is mnaged by HMOs here in IL mucifer Dec 2024 #26
It's just another way to deny services questionseverything Dec 2024 #28
Sad if this is what it takes tonekat Dec 2024 #8
Exactly. TBF Dec 2024 #13
Hell, if that is indeed what it takes now, the blame rests entirely with the gun worshipers for making it possible. Karasu Dec 2024 #37
When the people are denied legall and non-violent means of effecting change Orrex Dec 2024 #39
Without Recourse To Maintain Life, Liberty, And The Pursuit Of Happiness Mankind Turns To Extrajudicial Means MayReasonRule Dec 2024 #10
Guess the CEO got nervous. Vinca Dec 2024 #11
I'll bet. nt TBF Dec 2024 #12
. Hassin Bin Sober Dec 2024 #14
Ya bummer that came out day one of theirs was murder. Totally amplified what they wanted done LizBeth Dec 2024 #15
Timing is everything. Gaugamela Dec 2024 #16
Widespread "misinformation"? AllyCat Dec 2024 #17
They just had to throw that in, those evil lying fucks. SunSeeker Dec 2024 #29
Gee, I wonder why. stollen Dec 2024 #18
Watch for them to quietly do it anyways JoseBalow Dec 2024 #19
Agree. They're goliath and will do whatever the hell they want. ancianita Dec 2024 #21
Yes, they'll do what they want, area51 Dec 2024 #42
But the last thing they want is bad publicity. calimary Dec 2024 #49
So give the corp 'policy' boyz a cookie. ancianita Dec 2024 #20
The PR department earning their pay JoseBalow Dec 2024 #23
Safer that way. paleotn Dec 2024 #22
It borders on medical malpractice -- class action lawsuit, anyone? Rocknation Dec 2024 #24
I think the murder is why the Anesthesiologist Advocacy group issued their statement yesterday AZSkiffyGeek Dec 2024 #27
Why is the Anesthesiologist Advocacy group a "shitty organization"? pnwmom Dec 2024 #33
They're advocating for doctors who have screwed many friends of mine AZSkiffyGeek Dec 2024 #40
That's awful -- but no one among my friends or family has reported an experience like that. pnwmom Dec 2024 #41
This was with Aetna AZSkiffyGeek Dec 2024 #46
For the future, have you heard about the No Surprises Act? No one is supposed to find out pnwmom Dec 2024 #47
That's the law I heard of, thanks! AZSkiffyGeek Dec 2024 #48
My son just had major surgery with them ALBliberal Dec 2024 #25
Isn't that nice of them ............I could have seen it now on the consent form going turbinetree Dec 2024 #31
I imagine the execution murder of the UnitedHealthCare CEO figured heavily in their decision. patphil Dec 2024 #32
I guess senior management got the message after watching the country at large react to yesterday's shooting in NYC. W T F Dec 2024 #34
Gee. I wonder what could've POSSIBLY provoked this sudden change of heart. Because it sure as fuck wasn't done out of Karasu Dec 2024 #35
Public pressure does sometimes work! PortTack Dec 2024 #36
Why would they even admit in public that they were doing that? alarimer Dec 2024 #38
Ya think?! Xipe Totec Dec 2024 #43
I imagine that the dry cleaners tonekat Dec 2024 #44
Nobody seems to care that they were trying to implement Medicare billing standards? mathematic Dec 2024 #45
This wasn't "government negotiated and paid healthcare." pnwmom Dec 2024 #52
One insurance company has already pulled their "About Us" page off their web site. LiberalArkie Dec 2024 #50
My guess... Macrophylla Dec 2024 #51

4catsmom

(597 posts)
30. who cares
Thu Dec 5, 2024, 08:07 PM
Dec 2024

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.

hlthe2b

(108,384 posts)
5. "signficant" backlash? I'd bet so overwhelminng their systems were going down & they were probably
Thu Dec 5, 2024, 05:34 PM
Dec 2024

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.

questionseverything

(10,602 posts)
7. They didn't expect to get caught
Thu Dec 5, 2024, 05:42 PM
Dec 2024

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

questionseverything

(10,602 posts)
28. It's just another way to deny services
Thu Dec 5, 2024, 07:56 PM
Dec 2024

Insurance companies exist to collect premiums and deny claims

That is the entire business model in a nutshell

tonekat

(2,174 posts)
8. Sad if this is what it takes
Thu Dec 5, 2024, 05:50 PM
Dec 2024

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.

Karasu

(716 posts)
37. Hell, if that is indeed what it takes now, the blame rests entirely with the gun worshipers for making it possible.
Thu Dec 5, 2024, 10:40 PM
Dec 2024

They don't get to blame anyone else.

Orrex

(64,861 posts)
39. When the people are denied legall and non-violent means of effecting change
Thu Dec 5, 2024, 11:05 PM
Dec 2024

They will find other means of effecting change.

MayReasonRule

(2,480 posts)
10. Without Recourse To Maintain Life, Liberty, And The Pursuit Of Happiness Mankind Turns To Extrajudicial Means
Thu Dec 5, 2024, 05:57 PM
Dec 2024
This, is that.

LizBeth

(11,134 posts)
15. Ya bummer that came out day one of theirs was murder. Totally amplified what they wanted done
Thu Dec 5, 2024, 06:43 PM
Dec 2024

quietly.

SunSeeker

(55,050 posts)
29. They just had to throw that in, those evil lying fucks.
Thu Dec 5, 2024, 08:06 PM
Dec 2024

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

JoseBalow

(6,987 posts)
19. Watch for them to quietly do it anyways
Thu Dec 5, 2024, 07:06 PM
Dec 2024

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

calimary

(85,386 posts)
49. But the last thing they want is bad publicity.
Fri Dec 6, 2024, 05:27 AM
Dec 2024

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.

Rocknation

(44,902 posts)
24. It borders on medical malpractice -- class action lawsuit, anyone?
Thu Dec 5, 2024, 07:41 PM
Dec 2024

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

(12,740 posts)
27. I think the murder is why the Anesthesiologist Advocacy group issued their statement yesterday
Thu Dec 5, 2024, 07:50 PM
Dec 2024

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

pnwmom

(109,763 posts)
33. Why is the Anesthesiologist Advocacy group a "shitty organization"?
Thu Dec 5, 2024, 09:44 PM
Dec 2024

And what was not accurate about their statement?

AZSkiffyGeek

(12,740 posts)
40. They're advocating for doctors who have screwed many friends of mine
Thu Dec 5, 2024, 11:55 PM
Dec 2024

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

(109,763 posts)
41. That's awful -- but no one among my friends or family has reported an experience like that.
Fri Dec 6, 2024, 12:03 AM
Dec 2024

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

(12,740 posts)
46. This was with Aetna
Fri Dec 6, 2024, 01:21 AM
Dec 2024

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

(109,763 posts)
47. For the future, have you heard about the No Surprises Act? No one is supposed to find out
Fri Dec 6, 2024, 01:42 AM
Dec 2024

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

(12,740 posts)
48. That's the law I heard of, thanks!
Fri Dec 6, 2024, 02:23 AM
Dec 2024

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

turbinetree

(25,846 posts)
31. Isn't that nice of them ............I could have seen it now on the consent form going
Thu Dec 5, 2024, 09:07 PM
Dec 2024

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

patphil

(7,516 posts)
32. I imagine the execution murder of the UnitedHealthCare CEO figured heavily in their decision.
Thu Dec 5, 2024, 09:43 PM
Dec 2024

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

W T F

(1,175 posts)
34. I guess senior management got the message after watching the country at large react to yesterday's shooting in NYC.
Thu Dec 5, 2024, 09:44 PM
Dec 2024

Karasu

(716 posts)
35. Gee. I wonder what could've POSSIBLY provoked this sudden change of heart. Because it sure as fuck wasn't done out of
Thu Dec 5, 2024, 09:56 PM
Dec 2024

any sense of decency.

alarimer

(16,946 posts)
38. Why would they even admit in public that they were doing that?
Thu Dec 5, 2024, 10:49 PM
Dec 2024

Maybe they thought it was a slow news day?

I have no idea.

tonekat

(2,174 posts)
44. I imagine that the dry cleaners
Fri Dec 6, 2024, 12:27 AM
Dec 2024

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

mathematic

(1,551 posts)
45. Nobody seems to care that they were trying to implement Medicare billing standards?
Fri Dec 6, 2024, 12:31 AM
Dec 2024

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

(109,763 posts)
52. This wasn't "government negotiated and paid healthcare."
Fri Dec 6, 2024, 02:47 PM
Dec 2024

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

Macrophylla

(201 posts)
51. My guess...
Fri Dec 6, 2024, 09:29 AM
Dec 2024

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.

Latest Discussions»Latest Breaking News»Anthem Blue Cross Blue Sh...