Anthem is backing down on the anesthesiology cap in CT

HARTFORD, CT (WFSB) – An unpopular move to limit anesthesiology coverage through Anthem Blue Cross Blue Shield has drawn criticism from patients and state officials.

However, Connecticut’s comptroller announced Thursday that anesthesiology in the state would be covered by Anthem.

On Wednesday, Anthem released information about a cap on anesthesia insurance, saying surgery that extended beyond a certain period of time would not be covered. The change would have applied to Connecticut, New York and Missouri.

The only exception to the new change would be those under 22 and maternity care.

There is usually no time limit for anesthesia. The administration usually takes place for as long as the procedure lasts.

Anesthesiologists say every patient is different and that some surgeries take longer than others, depending on the patient’s age and health.

“We have to anesthetize for as long as the case lasts. For example, if someone needs a gallbladder removed and they are young and healthy, it might take 45 minutes, if they are older and sicker, it might take two or three hours,” said Dr. Kenneth Stone.

Comptroller Sean Scanlon said that after discussions with Anthem, the provider of health insurance for state employees, and many others across Connecticut, Anthem will no longer implement the policy restricting reimbursement for anesthesiologists.

“After hearing about this policy from people across the state, my office reached out to Anthem and I am pleased to announce that this policy will no longer be in effect here in Connecticut,” Scanlon said.

“That scared a lot of people. People were outraged and very concerned about this policy. And I think the story of how they’re turning it around is really about the story of people speaking up and using their voice and knowing that their voice matters in CT,” he continued.

Connecticut Attorney General William Tong said he has heard from people in the state about their concerns.

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

New York also intervened and prevented the plan from taking effect.

The policy would have taken effect in February and could have resulted in insurance coverage being denied to patients who may need more anesthesia because their surgery was difficult or unusual or a complication arose.

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