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Insurance Company Halts Plans to Limit Anesthesia Coverage During Surgery
After sharp criticism from anesthesiologists, an insurance company is halting its plan to limit the amount of time it would cover anesthesia used in surgeries and procedures.
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Gal_Tuesday
Joined 2003/07/01Visited 2024/12/05
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BREAKING: Anthem Blue Cross Blue Shield has now walked back their decision in New York as well as Connecticut after pressure from state officials.[image or embed] -- More Perfect Union (@moreperfectunion.bsky.social) December 5, 2024 at 4:17 PM
BREAKING: Anthem Blue Cross Blue Shield has now walked back their decision in New York as well as Connecticut after pressure from state officials.[image or embed]
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FTA:
The company said that the standards it's using to determine how long a surgery should last are consistent with industry standards and formulas set by the American Society of Anesthesiologists. Maternity-related care and pediatric services for patients younger than 22 will be excluded from this change, as there is more variability in the time needed for surgeries and procedures for these groups, Anthem said. But the American Society of Anesthesiologists has called for an immediate reversal of this policy, saying that Anthem has set an "arbitrary time limit" on surgeries that threatens individual patient care.
But the American Society of Anesthesiologists has called for an immediate reversal of this policy, saying that Anthem has set an "arbitrary time limit" on surgeries that threatens individual patient care.
#1 | Posted by Gal_Tuesday at 2024-12-05 11:19 AM | Reply
As much as the insurers would like to believe this, operating rooms are nothing like the Assembly line at Ford. The very idea that the patient might be penalized because of some delay or complication is in opposition to the quality practice of Medicine.
#2 | Posted by morris at 2024-12-05 11:27 AM | Reply
And people wonder why that CEO was shot yesterday.
#3 | Posted by qcp at 2024-12-05 11:28 AM | Reply | Newsworthy 3
I guess after it wears off, we're just supposed to bite down on a stick.
Said stick will also not be provided by insurance. You'd better bring a sterile one with you.
#4 | Posted by Whatsleft at 2024-12-05 11:34 AM | Reply
Rotten bastards. The lot of them.
#5 | Posted by LauraMohr at 2024-12-05 11:39 AM | Reply
Not crying for anesthesiologists. When I had my cataract surgery one came in, asked a question about my airway, waved a stethoscope over my chest and charged me 750 dollars. The actual anesthesia (light sedation) was monitored by a CNA and they charged 1200 dollars. Both were out of network, which I had no control over since the surgeon picks where the procedure is done.
#6 | Posted by mattm at 2024-12-05 11:46 AM | Reply | Newsworthy 2
Should have picked a better surgeon.
#7 | Posted by qcp at 2024-12-05 11:57 AM | Reply
-George Washington spent 40 years of his life with raging, pus-filled abscesses and raw, exposed nerves in the gums and remaining teeth in his mouth and blinked nary an eyelash.
-James Monroe took a partial musket ball to the shoulder and then sat calmly and smoked hashish with his boots splashing in a growing puddle of his own blood while a military doctor removed shards of metal with his dirty fingernails and then tied a catgut ligature around the partially severed circumflex artery that still protruded from the wound.
-Andrew Jackson walked around for 40 years with a lead bullet lodged in his left lung after shooting the man who fired it down like a dog in a duel. He would constantly wheeze and clear his throat while he spoke and occasionally hack up huge clots of congealed blood during speeches.
None of those fine Americans and notable Presidents needed anesthesia, and neither do you!
#8 | Posted by NerfHerder at 2024-12-05 12:04 PM | Reply
It is a common practice for an insurance company to limit coverage to get the provider to stop gouging them with their billings.
I'm not saying that a policyholder won't get stuck with a bill from the MD because the insurance company limited payment but the goal is to get the MD to bill for more time than they need to.
You all understand MDs can be greedier than 10 insurance companies at times right??
#9 | Posted by eberly at 2024-12-05 12:20 PM | Reply | Funny: 1
9
sorry I should have said "get the MD to stop billing for more time than they need to"
#10 | Posted by eberly at 2024-12-05 12:23 PM | Reply
Kennedy is going to make everybody healthy so you won't need anesthesia but just case he'll teach you how to use Thai-Chi
#11 | Posted by fortfisher at 2024-12-05 12:37 PM | Reply
Because people commonly ask if everyone they will come in contact is in network. Had a polyp removed once, the pathologist wasn't in network. MIL went to the ER. Radiology wasn't in network. Not something you commonly check when being evaluated for a stroke.
#12 | Posted by mattm at 2024-12-05 12:45 PM | Reply | Newsworthy 3
"Wake up! Time to die."
#13 | Posted by LegallyYourDead at 2024-12-05 02:01 PM | Reply
Because people commonly ask if everyone they will come in contact is in network.
Smart ones do.
An ER visit is wildly different than a planned surgery.
#14 | Posted by qcp at 2024-12-05 03:03 PM | Reply | Newsworthy 1
Update:
Insurance company halts plan to put time limits on coverage for anesthesia during surgery After sharp criticism from anesthesiologists, an insurance company is halting its plan to limit the amount time it would cover anesthesia used in surgeries and procedures. Anthem Blue Cross Blue Shield said on Thursday it would no longer move forward with the policy change. "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," the company said in a statement. "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."
After sharp criticism from anesthesiologists, an insurance company is halting its plan to limit the amount time it would cover anesthesia used in surgeries and procedures. Anthem Blue Cross Blue Shield said on Thursday it would no longer move forward with the policy change.
"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," the company said in a statement. "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."
#15 | Posted by Gal_Tuesday at 2024-12-05 05:26 PM | Reply
Looks like killing the CEO for United healthcare had an impact.
#16 | Posted by ClownShack at 2024-12-05 05:30 PM | Reply | Newsworthy 2
Seems to me that the people at Anthem Blue Cross want to stay in THIS side of the sod. Just sayin
#17 | Posted by LauraMohr at 2024-12-05 05:38 PM | Reply | Newsworthy 1
#16 | POSTED BY CLOWNSHACK
Someone may have gently reminded them that there are ~400 million guns in America and the hoi polloi are getting restless.
#18 | Posted by donnerboy at 2024-12-05 06:47 PM | Reply | Newsworthy 2
Sounds like they are backpedalling on this.
#19 | Posted by REDIAL at 2024-12-05 08:14 PM | Reply
Few more dead CEOs and America can be great again!
#20 | Posted by ClownShack at 2024-12-05 08:22 PM | Reply
Not crying for anesthesiologists. When I had my cataract surgery one came in, asked a question about my airway, waved a stethoscope over my chest and charged me 750 dollars. The actual anesthesia (light sedation) was monitored by a CNA and they charged 1200 dollars. Both were out of network, which I had no control over since the surgeon picks where the procedure is done. #6 | Posted by mattm
What's the Average Anesthesiologist's Salary? According to Salary.com, anesthesiologists can make anywhere between $373,000 and $488,100, with the median salary being $430,600. physiciansthrive.com
#21 | Posted by censored at 2024-12-06 07:46 AM | Reply
#12
Radiology is always effectively in network now unless you intentionally choose somebody out of network. Has been since the No Surprises Act took effect in 2022.
I actually experienced that firsthand in 2022. I got sent to a radiology office for some x-rays that year, I actually asked at the front desk if they were in-network, I was assured they were. A couple months later an EOB showed up on the insurance website showing that I was about to get a bill for several hundred dollars because the radiologist was out of network. I was all set to have fun telling them I was not going to pay, because new law. But I didn't even end up having to, I never got that bill, a few months after that a new EOB showed up to replace the first one, it was fully covered.
#22 | Posted by DarkVader at 2024-12-06 08:10 AM | Reply
#2 | Posted by morris
Actually they are getting closer and closer to assembly lines. I mean there have always been surgery days that a surgeon goes in and does x surgeries that day. NOW, doctors are signing contracts with hospitals that employ them that they will do so many surgeries per week and the numbers to me are stupid high. Two of them I know have talked about it. The Nurses I know that work with them says it makes them less than great surgeons to say the least. They are rushed and have more complications. Since those complications usually result in more billable hospital and doctor hours - do you think the hospitals actually care? Hospitals have been losing money since COVID, so they really don't care now. The one doctor I know does cosmetic surgery. I personally know 3 women that had reconstructive surgery done by him in the last couple of years that had major complications. What's his MO? He blames the patient for not doing what they were supposed to do post op. Let me tell you these women are mad because they DID DO what they were instructed to do... And none of them even sued...
#23 | Posted by GalaxiePete at 2024-12-06 11:14 AM | Reply
#22 | Posted by DarkVader
That was some great legislation. Soooo many people got screwed by things like that. It is like this - I am going to XYZ Hospital/Clinic/Whatever. Any service there should be rendered by that provider or billed as if it were. These places all started breaking off into their own entities BECAUSE of our broken insurance in this country. I am 100% for a single payer system period. I have experienced two of them as an outsider non-resident - YES PLEASE!
#24 | Posted by GalaxiePete at 2024-12-06 01:50 PM | Reply
Current update from NYC local news ...
abc7ny.com
... he investigation into and search for the masked gunman who stalked and killed the head of UnitedHealthcare moved into its third day on Friday, leading to a trove of new developments. The NYPD is now saying they believe the suspected shooter has left the city. After biking out of Central Park, the man believed to be the shooter went on foot at Columbus Avenue and West 86th Street and hailed a taxi, which took him north to the George Washington Bridge Bus Station, a Port Authority-operated bus terminal at 178th Street. He never exited the facility, and he is believed to have taken a bus out of New York City, officials say. As a result, the FBI is now joining the manhunt for the shooter, according to law enforcement sources. Investigators are trying to track down the suspect around the country and have already followed leads in multiple states. The bus the suspect is believed to have boarded out of the city made six or seven stops. ...
The NYPD is now saying they believe the suspected shooter has left the city.
After biking out of Central Park, the man believed to be the shooter went on foot at Columbus Avenue and West 86th Street and hailed a taxi, which took him north to the George Washington Bridge Bus Station, a Port Authority-operated bus terminal at 178th Street.
He never exited the facility, and he is believed to have taken a bus out of New York City, officials say.
As a result, the FBI is now joining the manhunt for the shooter, according to law enforcement sources. Investigators are trying to track down the suspect around the country and have already followed leads in multiple states.
The bus the suspect is believed to have boarded out of the city made six or seven stops. ...
#25 | Posted by LampLighter at 2024-12-07 12:42 AM | Reply
@#25
If you're interested, more details at that link.
#26 | Posted by LampLighter at 2024-12-07 12:44 AM | Reply
@#25, 26
Wow.
I messed that up, big time.
Totally the wrong thread.
Apologies abound.
#27 | Posted by LampLighter at 2024-12-07 12:47 AM | Reply
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