Anthem Blue Cross Blue Shield wants to limit the duration of anesthesia during operations

There is usually no set time limit for anesthesia during a surgery or procedure. Anesthesia is administered for as long as the procedure lasts – a decision made by the treating physician, not the anesthesiologist.

“The problem here is that the time and duration of the operation is a function of the surgeon, not the anesthesiologist. “The anesthesiologist is really at the mercy of the surgeon, no matter how long it takes him to do the operation well,” said Dr. Dhivya Srinivasa, founder and chief surgeon of the Institute for Advanced Breast Reconstruction in Los Angeles.

“In my field, I am a reconstructive breast cancer surgeon. There is a wide range in how long it will pay off depending on the complexity,” Srinivasa said.

In a statement, an Anthem BCBS spokesperson said the decision was made to “protect against potential overbilling by anesthesia providers” as part of the company’s “ongoing efforts to improve the affordability and accessibility of care.”

It will use “CMS physical labor time values ​​to determine the appropriate number of minutes” for procedures, the spokesman said, referring to the Centers for Medicare and Medicaid Services.

Dr. Donald Arnold, the president of the American Society of Anesthesiologists, sharply questioned the way the insurer set the deadlines.

“No, it’s not part of Medicare or Medicaid,” he said. “No one else has a system like this.”

The CMS physician working hours values ​​can be found on the CMS website.

“Medicare has some data,” Arnold said. “We don’t know the purpose of the data. We don’t know the origin. We don’t know how it is calculated. We don’t know anything about it except that we can find the spreadsheet and download it. CMS has not answered our questions so we can understand how it was designed.”

CMS did not immediately respond to a request for comment.