How much does an hour of anesthesia cost? According to Blue Cross Blue Shield, coverage will cap after a certain period of time – regardless of whether the surgery is completed or not

A new policy from one of the country’s largest insurers that would limit payment for anesthesia claims is sparking widespread outrage among lawmakers and doctors.

According to the American Society of Anesthesiologists, Anthem Blue Cross Blue Shield plans to “unilaterally” stop covering anesthesia claims for medical services and surgeries that last longer than an “arbitrary time limit.”

“This is just the latest in a long line of appalling behavior by commercial health insurers seeking to increase profits at the expense of patients and physicians who provide primary care,” Dr. Donald E. Arnold, the group’s president, said in a November statement from the group. “It is a cynical cash grab by Anthem designed to exploit the commitment that anesthesiologists make thousands of times every day to provide their patients with expert, complete and safe anesthesia care.”

According to the group, the policy change will take effect in Connecticut, New York and Missouri.

A notice to Anthem providers in New York said the policy goes into effect in the state on February 1 and will base payment decisions on the Centers for Medicare and Medicaid Services (CMS) physician work-hour values, formulas that help achieve this to determine government payments to doctors.

“Claims where anesthesia time exceeds the established limit will only be paid up to the amount determined by CMS,” the provider’s notice said. Patients under 22 and those receiving maternity care are exempt.

Another provider announcement reported by NPR describes the same policy taking effect in Colorado starting in March.

The Independent Anthem has reached out for comment.

New York Gov. Kathy Hochul called the policy “outrageous,” while Sen. Chris Murphy of Connecticut called it out in a post

“And for what? “Just to increase corporate profits?” he continued. “Reverse this decision immediately.”

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Doctors, meanwhile, warned that the policy could impact care and fails to take into account the many reasons why an operation or procedure could take longer than a preset formula.

“There are many real-world examples that I can cite as a physician that illustrate that a set time limit for anesthesiology coverage is not useful because many other medical factors come into play,” said Jeff Gordon, a Republican senator and doctor for Connecticut wrote in a statement last month. “Every patient is different. Every operation is different.”

According to the Health Care Cost Institute, the average price of anesthesia for outpatient visits increased 20 percent to $989 between 2018 and 2022.

The company designed the measure as a way to actually reduce costs for patients by standardizing claims.

“At Anthem, we strive to make healthcare easier and more affordable,” the company told CNN. “One way to achieve this goal is to ensure that claims are accurately coded and providers receive fair compensation for the services they provide to members. Improper coding drives healthcare costs higher than they otherwise would be.”

Eric Levitz, a correspondent for the progressive news channel Vox, argues that the policy change could have an advantage, arguing in a post “Make everyone pay higher premiums to support their extortionate billings.”

The heated public debate over health care costs follows the shooting of UnitedHealthcare CEO Brian Thompson outside a New York City hotel on Wednesday in what police suspect was a targeted attack.