Amid backlash, insurer shelves plan to limit anesthesia coverage in Missouri

Anthem Anesthesia

Signage is displayed the outside of the corporate headquarters building of health insurance company Anthem in Indianapolis, Tuesday, May 14, 2019.

JEFFERSON CITY — After facing criticism over a plan to limit coverage of anesthesia, one of Missouri’s largest health insurers backtracked from the policy Thursday.

Anthem Blue Cross Blue Shield said in a statement it was dropping the plan, citing “widespread misinformation” about how the change would work.

“As a result, we have decided to not proceed with this policy change,” said Anthem spokeswoman Emily Snooks.

The decision came after Missouri lawmakers and groups representing anesthesiologists raised alarm bells, concerned that the change would force patients to pay out-of-pocket for anesthesia if a medical procedure goes longer than expected.

House Speaker-elect Jon Patterson, a physician, heard the rumblings of outrage earlier this week and began making calls to Anthem Thursday in an attempt to gain clarity on the controversial policy.

“It’s actually kind of unbelievable,” the Lee’s Summit Republican said. “As a surgeon, my initial impression is that this will be harmful to patients by now putting artificial time limits on procedures.”

The insurer, which provides health coverage to an estimated 2.1 million Missourians, announced last month it will no longer pay for anesthesia care if a surgery goes beyond a specific time limit. The policy was set to go into effect in Missouri Feb. 1.

The new billing scheme would not have applied to patients under the age of 22 or maternity-related care, according to Anthem.

Snooks said the plan is off the table for now.

“To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services. The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines,” she said in an email.

The insurance giant’s initial decision drew scorn from the American Society of Anesthesiologists, which called the now-scrubbed policy a “cynical money grab.”

“With this new policy, Anthem will not pay anesthesiologists for delivering safe and effective anesthesia care to patients who may need extra attention because their surgery is difficult, unusual or because a complication arises,” the organization said in a statement.

The Missouri Society of Anesthesiologists also strongly opposed the change, saying it posed a significant threat to the safety of Missouri patients and undermined the critical role anesthesiologists play in surgical care.

“Our anesthesiologists are committed to providing safe, effective and individualized care to every patient,” said Dr. Todd Glenski, president of Missouri Society of Anesthesiologists.

Rep. David Tyson Smith, D-Columbia, said on social media Thursday that he planned to take action if the policy was not reversed.

“This is dangerous, egregious and appalling. I’m going to file legislation to prevent Blue Cross from doing this to Missourians,” Tyson Smith wrote.

Before the company backtracked, Patterson said he hoped the policy would be scuttled before lawmakers return to the Capitol in January.

“I hope this gets resolved far before legislation is required. But I would not rule out a legislative solution because this really is a patient safety issue,” Patterson said. “I’m very concerned by the way this was rolled out.”

The dispute comes just days after Blue Cross and Mercy, one of the St. Louis region’s largest health systems, announced they had reached a new contract agreement allowing Anthem customers to have medical care with Mercy providers fully covered.

The agreement includes all Missourians covered by Anthem’s employer-based Medicare Advantage, the Affordable Act Marketplace and Healthy Blue Medicaid plans.

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