Health insurer abandons limits on anesthesia coverage for Missouri patients after outcry

Health insurance giant Anthem, a large subsidiary of Blue Cross Blue Shield, backpedaled Thursday, Dec. 5, on a November policy change that would have limited their coverage of anesthesia during certain operations in Missouri and elsewhere.

“There has been significant widespread misinformation about an update to our anesthesia policy. As a result, we have decided to not proceed with this policy change,” said Anthem spokesperson Emily Snooks in an email.

“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.”

Here’s what to know about the controversial policy.

What changes to anesthesia coverage did Anthem propose?

Anthem’s policy change would have limited anesthesia coverage based on the expected length of various surgical procedures, potentially denying coverage for procedures that end up taking longer than expected due to complications. The policy change drew outcry from patients, medical professionals and elected officials.

“The word egregious comes to mind,” said Dave Dillon, a spokesperson for the Missouri Hospital Association. “This reversal is good news for patients and providers. Bad policies like this seldom stand when there’s transparency.”

The policy change drew national attention Wednesday, Dec. 4, following the fatal shooting of United Healthcare CEO Brian Thompson by an unidentified assailant in New York City.

United Healthcare is unaffiliated with Anthem or Blue Cross Blue Shield, but both health insurance giants were brought into a larger conversation about the for-profit health insurance industry.

What have elected officials said about the policy?

House Majority Leader Jonathan Patterson, a Lee’s Summit Republican, said in a statement before the reversal that he hoped the situation would be resolved before lawmakers had to step in. However, Patterson, a doctor by trade, said he wouldn’t rule out legislation, calling it a “patient safety issue.”

“As a surgeon my initial impression is that this will be harmful to patients by now putting artificial time limits on procedures,” said Patterson, who is also the presumptive next House speaker. “I’m very concerned by the way this was rolled out.”

In the meantime, at least one Democratic lawmaker had already signaled a plan to address the issue.

“This is dangerous, egregious and appalling,” Rep. David Tyson Smith, a Columbia Democrat, said on social media. “I’m going to file legislation to prevent Blue Cross from doing this to Missourians.”

The Star’s Kacen Bayless contributed reporting.

Do you have more questions about health care in Missouri and Kansas? Ask the Service Journalism team at [email protected].

©2024 The Kansas City Star. Visit kansascity.com. Distributed by Tribune Content Agency, LLC.