4 ms·
You refer to Anthem walking back its decision to charge anesthesiologists according to Medicare standards (average time of procedure, rather than recorded t
by inferiorhuman 2y ago
You refer to Anthem walking back its decision to charge anesthesiologists
according to Medicare standards (average time of procedure, rather than
recorded time).
Medicare reimburses anesthesia providers for the entire time the patient was under anesthesia. This is captured by time units. Anthem was planning to implement a hard cap based on Physician Work Time which is entirely different. In essence Anthem is weaponizing Medicare in an attempt to deflect blame.
https://www.gao.gov/assets/gao-21-41.pdf https://www.gao.gov/assets/gao-21-41.pdf
https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue-shield-anesthesia-anthem https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue...
- atonable 2y agoYou're right, I misunderstood how Medicare covers anesthesia. But the GAO report you shared strengthens Anthem's argument: they pay far more for anesthesia compared to Medicare, a sign that the providers are overcharging. And the stats about unreliability of recorded procedure times are still compelling. https://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance https://www.vox.com/policy/390031/anthem-blue-cross-blue-shi...
- inferiorhuman 2y agoa sign that the providers are overcharging Or a sign that private insurance companies are too burdensome. UHC is well known both for constantly changing the claims process and for preemptively denying valid claims. Arguably private insurance companies need to pay more because they are a significantly bigger hassle to deal with than Medicare and require a legion of support staff.