Originally published by our sister publication Anesthesiology News

Following Anthem Blue Cross Blue Shield’s proposal—and subsequent reversal—to impose a time limit on anesthesia services, Congress is considering a bill that would ban insurance companies from setting such limits on anesthesia care.

The Anesthesia for All Act, sponsored by Rep. Ritchie Torres (D-N.Y.), would “prohibit health insurers ... from imposing arbitrary time caps on reimbursement for anesthesia services and for other purposes.”

If passed, the bill would direct the Department of Health and Human Services inspector general to conduct audits to ensure health insurance companies are complying with the law.

“We cannot trust insurers to do right by doctors and patients out of the kindness of their hearts. There is a need for legislation that prevents any insurer anywhere in America from micromanaging the length of anesthesia care in a medically necessary surgery. The purpose of medicine should be to prevent pain, rather than cause it through the denial of anesthesia,” Torres said in a statement.

In November, Anthem announced it would no longer pay for anesthesia care if the surgery or procedure went beyond an arbitrary time limit, regardless of how long it actually took. Anthem was set to implement this policy on Feb. 1, 2025, in Connecticut, New York and Missouri.

The American Society of Anesthesiologists (ASA)—who along with other surgical safety advocates was instrumental in notifying the public of Anthem’s plans—said the proposed policy was “inconsistent with prevailing standards, regulations and billing norms, and revealed a diminished dedication to patient safety on the part of Anthem.”

The ASA also noted that the proposal reflects a larger trend among commercial health insurers to “unilaterally undercut established anesthesia billing and payment norms that recognize anesthesia services and care, especially for care provided in emergency situations, to patients of extreme age and for more complex and vulnerable patients who require additional care from an anesthesiologist.” For example, earlier this year: 
     • Anthem withdrew payments for qualifying circumstances in several states; and  
     • Blue Cross Blue Shield discontinued payments for physical status modifiers in five states, and Aetna followed suit. 

It’s the ASA’s position that these insurance policy decisions targeting anesthesiologists are not cost-saving solutions; rather, they serve to shift costs from the insurers to hospitals, physicians and patients.

By Anesthesiology News Staff