TLDR: The insurance company has a new policy, set to take effect in February 2025, where they decide how much anesthesia is needed for surgeries. They won’t pay for any anesthesia over that, with exemptions for maternity and pediatric cases and for Connecticut providers.
The article also notes the insurance company reported a $2.3 billion net income increase in June 2024.
Edit to update: Anthem now says they won’t put this policy into effect
So, at the absolute most charitable interpretation, this punishes patients for having a slow surgical staff or for a surgery having complications. Like most insurance things, punishing the patient for shit completely outside of their control.
On top of this, best outcome of this (for doctors to try and ensure their patients don’t need to decide between potential financial ruin or surgery) would be for all surgical departments to wildly inflate their surgery times so they can’t ever be over estimate. This will significantly reduce the amount of surgeries able to be completed per day, and hike up the price even more as they have to bill for more time.
The only possible justification for this is attempting to find another place to lower financial costs to the insurance company at any “cost”. I miss when these people had enough shame to not go this mask off.
This actually sets a time limit for anesthesia regardless of procedure or estimated time from the doctors.
It’s entirely up to the insurance company to set an arbitrary time with which they think medical care should be provided within and deny past.
It’s nothing but appalling cruelness for the sake of it, and a few extra dollars for a CEO and board of Directors that deserve the opposite of health care.