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nottheonion·Not The OnionbyChaosCoati

Anthem Blue Cross Plans Won't Cover Anesthesia for Entire Length of Surgeries That Exceed Time Limit

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

https://www.msn.com/en-us/health/other/anthem-blue-cross-plans-won-t-cover-anesthesia-for-entire-length-of-surgeries-that-exceed-time-limit-it-s-a-cynical-money-grab/ar-AA1vhOSBOpen linkView original on midwest.social
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77 replies

https://www.change.org/

Was thinking about it. Even if it's not taken seriously and even if it never gets Joe Biden signature, this would be a real good way to send a message to the nation. Just how many people the absolute number of people who are angry to the point of letting people kill CEO's Because of injustice and inequality.

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lemmy.world

He would have to be known. I would rather the guy stay anon so his life isn't ruined. He can live the rest of his life without the fear of corpo vengeance. Also he probably would never be able to be insured again lol. Either that or he's terminal and his care was denied so he had nothing to lose.

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I got diagnosed with stage 3 cancer in 2022 (cured now). I can totally see how someone could go full The Punisher on healthcare execs if their life-saving treatment was denied. The problem isn't facing your own mortality, that doesn't take long to process. What is an impossible pill to swallow is the thought of leaving your loved ones drowned in an avalanche of medical debt and possible financial ruin. Fuck that.

Deny
Depose
Defend

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0p3r470rreply
lemm.ee

Doubtful. It’s probably a state crime.

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gibmiserreply
lemmy.world

Symbolic, doesn't matter really.

It's about sending a message

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jonnereply
infosec.pub

The patient has a right to defend themselves and should get access to 2000 pound bombs.

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jonnereply
infosec.pub

The IDF likes to defend themselves with 2000 pound bombs.

2
lemmy.world

That's a nice CEO you got there. Be a shame if something happened to them.

93

Didn't verify, but someone said it was only reversed in like one out of the five proposed states. Figures

13

usually when a thing is reversed due to outrage, the entity will simply wait a few months to quietly put said thing into effect again

9

Well I certainly hope we don't need to see someone step in to explain to the company how wrong this is.

62
lemmy.world

“One of the reasons that she has remained so active in this particular field is because she has seen what it does to people when they can’t get insurance to cover the healthcare they need."

Sadists.

81

“One of the reasons that she has remained so active in this particular field is because she has seen what it does to people when they can’t get insurance to cover the healthcare they need."

FTFY. It makes the people desperate enough to buy her product.

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raoulreply
lemmy.sdf.org

"One of the reasons that she has remained so active in this particular field is because she has seen what it does to people when they can’t get insurance to cover the healthcare they need,” Money Inc. wrote.

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lemy.lol

So they can hurt millions of people all just a little bit more but somehow they are the good guys worth protecting?

Yeah, we'd be right to start carving names into bullets too. And yet people in charge can't figure out why protecting these people and their money means the mass populace hates them.

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sh.itjust.works

I'd say any surgery without anesthesia is hurting more than a little bit. What are we, Gaza?

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NABDadreply
lemmy.world

They aren't saying you won't get anesthesia. That would be wrong.

You just have to pay the bill when you wake up.

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You're assuming doctors will make their decisions based on the legitimate medical needs of their patients.

But hospital policies are often chosen for other reasons, such as ensuring all bills get paid in full, and no lawsuits are filed by anyone who has enough lawyers to win.

Those policies can put a doctor's employment and/or license in jeopardy.

Doctors are already choosing to let women die rather than get in trouble for doing medically necessary abortions.

Will they cut anesthesia short and hope they can finish sewing in time? Unlikely, but not nonzero.

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From January 2011 to November 2014, she served as the chief executive officer of UnitedHealthcare

Small world, when you move in those circles. Imagine how these people convince themselves they're doing something good and admirable.

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Round is a shape. She's in shape! Pre-existing condition. Claim denied.

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sopuli.xyz

The fact that there aren't riots in the US demanding universal care simply baffles me.

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P00ptartreply
lemmy.world

Who needs roots when killing CEOs is more effective?

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Klearreply
lemmy.world

Is it effective though? I mean, it's fun, but I don't see it actually improving the situation.

14

It's not a one time solution, it's a lifestyle change. You have to keep doing it.

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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.

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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.

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lemmy.ca

Of course, because in the USA, insurance companies think they understand medicine better than doctors.

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Anthem Blue Cross Blue Shield said in a statement that its decision to backpedal resulted from “significant widespread misinformation” about the policy.

Ah, yes, if people complain about being mistreated, it is always "Our plan was misunderstood", or "The critique is based on misinformation"...

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How did they figure out the amount because the different people have different tolerances. My brother had a surgery that had not started and they were like. Your still awake. When meeting with the anethsiaologist before surgery he has to mention he may need a bit more than normal plus I believe there is a weight thing. Is the amount allowed assuming a worst case longest surgery with person who requires the most anesthia to six sigma of the population.

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I remember some jokes around it being about cell receptiveness. Like their receptors don't react to taking pigment the same way they don't react to the anesthesia as well. If so, it would likely be a genetic trait, so the more natural red heads that have extremely low pigment may require more anesthesia to keep them under. But I'm no doctor, and most of those jokes had to do with their soul not being around to pick up the call 🤷.

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Interesting timing for this given the United healthcare CEO assassination yesterday

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DokPsyreply
lemmy.world

I would find it hilarious if it sparks class solidarity, personally

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sh.itjust.works

Noticed the Connecticut exemption, must be a law there. I'll take "laws you wouldn't think could be necessary" for $400, Alex. Guess we better get California working on that as well.

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You'd be surprised how many of them there are. Massachusetts has a law that requires insurance companies to cover transgender care, including both HRT and surgeries, because insurance wouldn't cover any of them otherwise. Trans related surgeries are classified as "cosmetic" and therefore not necessary or life-saving according to insurance companies, despite the mountain of studies saying how important they can be for people's quality of life.

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Good for MA. Hoping it doesn't become moot because of a national ban on trans care. Bullies always start with the most vulnerable.

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The doctor took too long, and now your coverage is gone. That’s what happened. Bakow!

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lemmy.world

and for Connecticut providers

Anybody from Connecticut care to respond. Why is your state so special?

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From a more recent article where Anthem now says they won’t implement this policy:

Connecticut comptroller Sean Scanlon said the “concerning” policy wouldn’t affect the state after conversations with the insurance company. And New York Gov. Kathy Hochul said in an emailed statement Thursday that her office had also successfully intervened.

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Don’t they have the closest thing to universal healthcare in the US?

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Insurance pays out until outcome and not treatment. Meaning of they don't cure you, insurance will have to cover until you die.

And if they kill you while trying to cure you, every care provider in the chain pays 10-times the cost (total insurance paid by patient over all the years) based on liability to the family else insurance pays 20-times total insurance cost to family.

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