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Anthem Blue Cross Blue Shield to cap anesthesia coverage after certain time frame
Rochester First (NY) ^

Posted on 12/05/2024 6:08:36 AM PST by TigerClaws

ROCHESTER, N.Y. (WROC) — Those who use Anthem Blue Cross Blue Shield insurance will likely soon have to pay out of pocket for anesthesia services, should their surgeries fall outside a specific time limit. This applies to patients in New York State, Missouri and Connecticut.

Officials with BCBS announced that this would begin with claims processed on or after Feb. 1, 2025. According to BCBS, “We will utilize the CMS Physician Work Time values to target the number of minutes reported for anesthesia services.” Any surgery that goes beyond the set limit, will no longer be covered.

There are some exemptions to this. Those include patients under the age of 22 and patients in need of maternity-related care.

News 8 reached out to Anthem BCBS and have not received a response. We have also contacted Excellus BCBS, which is a separate company, and were told they will get back to us when they have more information to share.

Wednesday night in response to this news, Governor Kathy Hochul wrote via X (formerly Twitter), “Outrageous. I’m going to make sure New Yorkers are protected.”


TOPICS: Business/Economy; Culture/Society; News/Current Events; Politics/Elections
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1 posted on 12/05/2024 6:08:36 AM PST by TigerClaws
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To: TigerClaws

You’ve been under for 18 minutes..no more gas for you pal!


2 posted on 12/05/2024 6:12:57 AM PST by The Louiswu (Pray for Peace in the world.)
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To: TigerClaws

In the past Anesthesiologists routinely charged in excess of what the BC/BS of the world paid. Yes, it was a patient’s responsibility to pay the difference.


3 posted on 12/05/2024 6:13:39 AM PST by Oystir ( )
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To: TigerClaws

Why just those states?

It seems those are “problem” states where practices may be less than optimal.


4 posted on 12/05/2024 6:16:35 AM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: TigerClaws

Incredibly, I agree with Hochul on something. Perhaps, though, Kathy, if our health care system wasn’t strained by millions of unhealthy and often diseased illegal aliens (and by a significant subset of that group demanding free maternal care), the bean-counters at the insurance companies wouldn’t be so desperate.


5 posted on 12/05/2024 6:16:45 AM PST by drwoof
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To: TigerClaws

Fentanyl from the street might come in handy in the future. Oh my insurance cut me off, no problem, brought my own Heroin.


6 posted on 12/05/2024 6:17:50 AM PST by teevolt
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To: TigerClaws

I guess shootings don’t get the attention they used to.


7 posted on 12/05/2024 6:25:08 AM PST by redangus ( )
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To: TigerClaws

A BYPASS IS 5 HOURS or more, depending on the # of blockages, after they get setup. Some up to 10+ hours. They only fast 1 is a colon screen, which Cologuard use could reduce need for. Preempted Covid Heart/Cancer


8 posted on 12/05/2024 6:25:16 AM PST by GailA (Welcome back Jesus and President Trump. We missed you.)
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To: TigerClaws

America needs “Health Care Free Trade Zones.”

It would be a geographical entity within each state where Doctors could establish practices and hospitals, where taxes are very low, doctors would only charge cash, where 3rd party payers are not allowed, where FDA rules are limited, where tort liabilities are capped.

Maybe Indian reservations can have them, where tribal sovereignty rules could apply.

Regardless, Americans will need a second system to develop, alongside the bloated, expensive, dysfunctional one we have in many states, which is destined for collapse.


9 posted on 12/05/2024 6:39:14 AM PST by PGR88
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To: The Louiswu

You’ve been under for 18 minutes..no more gas for you pal!


Next up:
“We’re half way through your triple by-pass heart operation, can you afford the other half out of pocket? If not, we’ll just call it good and go on to the next patient.”


10 posted on 12/05/2024 6:39:43 AM PST by PIF (They came for me and mine ... now its your turn)
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To: TigerClaws

This is good.

I am tired of fraudulent doctors and anesthesiologists over-charging their hours, forcing the rest of us to pay.

If you think there are no such crooks who defraud the system, then don’t reply to this. While the insurance companies are no angels, they would not need to enact these rules if someone didn’t already game the system.

At least BCBS is not as fraud-filled as Medicare/Medicaid.


11 posted on 12/05/2024 6:42:15 AM PST by Erik Latranyi (This is the end of the Republic....because we could not keep it.)
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To: Erik Latranyi

Anesthesiologist trickle billing has been driving me crazy for years. Never in network it seems and totally unpredictable amounts.


12 posted on 12/05/2024 6:50:21 AM PST by Codeflier (Don't worry....be happy)
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To: GailA

Colon screening does not require anything, I have done three without any drugs. The anathiesist is standing there ready but it is totally unnecessary. They are uncomfortble not paiful.


13 posted on 12/05/2024 6:59:55 AM PST by JAKraig (my religion is at least as good as yours.)
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To: Oystir

I was charged $2,000 for a shot of saline.


14 posted on 12/05/2024 7:17:39 AM PST by packagingguy
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To: The Louiswu

YOU will still get the gas——But YOU WILL HAVE TO PAY FOR IT.


15 posted on 12/05/2024 7:29:16 AM PST by ridesthemiles (not giving up on TRUMP---EVER)
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To: TigerClaws
Between March and September I had multiple occasions to be anesthetized. A "double header" colonoscopy and trans-oral endoscopy to search for the gastric bleed. A gall bladder removal was next. Yet another with an ERCP (a trans-oral endoscopy with some surgery added) where and cancer tumor was located in my "ampulla". The Whipple procedure ranges from 4 to 12 hours. Mine was 4 with a great surgeon. Unfortunately, my renal artery was nicked. More surgery as interventional radiology "embolized" the bleeder. Not a small bleed either. 10 transfusions to keep me alive while the bleed was patched. More surgery to install drains so the blood in my abdominal cavity could drain.

I would be really screwed if any of those procedures were denied anesthesia for some political gamesmanship. I've returned to work as of Nov 25 and feeding the greedy tax monster again. My fed taxes alone are $67k for this year.

16 posted on 12/05/2024 7:41:30 AM PST by Myrddin
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To: Oystir

Their fees have long been out of control.

Hospitals should have in-house staff for that and manage costs accordingly.


17 posted on 12/05/2024 7:45:35 AM PST by 9YearLurker
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To: PIF

“Or if you’d rather, here’s a bullet you can bite.”


18 posted on 12/05/2024 8:00:53 AM PST by Savage Beast (Fight! Fight! Fight! God Bless America! Trump won because good TRiUMPhed over evil.)
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To: TigerClaws

If I read this correctly and if it’s true this cannot be allowed to happen.

I don’t know who would stop it or how, but the reasons to prevent this change are legion.


19 posted on 12/05/2024 8:03:55 AM PST by Jim Noble (Assez de mensonges et de phrases)
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To: Myrddin

“Mine was 4 with a great surgeon. Unfortunately, my renal artery was nicked.”

Sorry you went through all of that, but a great surgeon? Love, sounds like he was in a hurry if he nicked your renal artery and didn’t know it and fix it immediately.


20 posted on 12/05/2024 8:52:29 AM PST by FrogMom (Time marches on....)
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