Anthem says it won't implement policy limiting coverage of anesthesia in CT

Anthem Blue Cross Blue Shield will not implement a policy to limit coverage of anesthesia, according to the state comptroller.

The health insurance provider had said it would no longer pay for anesthesia care if a surgery or procedure went beyond a specific time limit for patients in Connecticut, New York and Missouri.

Anthem had announced the new policy last month. It told patients that they it was going to change how it evaluated billed time starting Feb. 1, 2025 and policyholders could file a claim dispute if they disagreed with a claim reimbursement decision.

“After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I'm pleased to share this policy will no longer be going into effect here in Connecticut,” State Comptroller Sean Scanlon said in a statement on Thursday.

But it’s unclear when the decision to shelve the policy in Connecticut was made. What is clear is it wasn’t pressure overnight.

State Senator Jeffrey Gordon said he was alerted to the potential policy change in early November. He began fighting the policy with local and national anesthesiology groups.

“I’ve been fighting on this for a bit of time, so I am proud of the fact to have lead the charge with my anesthesiologist colleagues,” he said in an interview Thursday.

In a letter from Anthem’s senior director of government relations to Gordon dated Nov. 22, Anthem highlights the concerns of the senator, but indicated the policy would not impact Connecticut anesthesia providers, as they are “exempt from this update.”

The letter indicates twice Connecticut anesthesiologists would not be impacted.

Gordon went on to say the letter didn’t completely satisfy his concerns. He was still concerned about future policy changes, vowing to keep the fight up.

“This is not a good patient care policy, no doctor would think it would be, because we understand patient care,” Gordon said.

A spokesperson for Anthem Blue Cross and Blue Shield in Connecticut released a statement on Thursday afternoon.

“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. 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," the spokesperson said.

Following Anthem's official statement, Gordon again claimed victory, saying in a follow-up statement, “This apparent reversal is a very good thing for people in Connecticut who need care.”

The American Society of Anesthesiologists said the plan would have required Anthem Blue Cross Blue Shield customers to pay out of pocket for anesthesia if a surgery or procedure went longer than expected.

Scanlon said Anthem Blue Cross Blue Shield will no longer be implementing the policy to limit coverage of anesthesiology after conversations with the company, which is the provider for the state employee health plan and many others throughout Connecticut.

The Connecticut Hospital Association said it is their understanding that the policy would not apply to anesthesia providers in Connecticut.

Attorney General William Tong also issued a statement on Thursday afternoon.

“Good. The anesthesia coverage cap was a terrible policy. Neither patients nor anesthesiologists can control the length of a surgical procedure once it begins. What did Anthem expect doctors to do? Wake patients up in the middle of surgery? I’m glad Anthem listened to patients and doctors and reversed course,” Tong said in a statement.