Now, several states are taking legislative action to ban such time limits altogether.
David Vierra, MD, an anesthesiologist with Providence Medical Group-Napa (Calif.), told Becker’s that imposing time limits on anesthesia reimbursement would “further deteriorate anesthesia reimbursement, leading to further pressure on hospitals and ASCs to make up the difference, more anesthesiologists leaving medicine, and further reductions in access to care.”
Beyond state-level efforts, Rep. Ritchie Torres (D-N.Y.) has introduced a bill in the House to ban time caps on anesthesia reimbursement nationwide. The four-page bill, titled the Anesthesia For All Act, would prohibit time-based caps and direct the Department of Health and Human Services’ inspector general to audit insurers for compliance.
Here are four states with proposed legislation to ban anesthesia time limits:
Republican state Rep. Bill Hauter, MD, has introduced a bill prohibiting insurers from setting time-based restrictions on anesthesia reimbursement. The legislation would grant the state’s Department of Insurance enforcement authority to penalize insurers attempting to impose such limits.
Missouri lawmakers have proposed a bill that would prevent insurers from restricting anesthesia coverage. Sponsored by Democratic Rep. David Smith, the bill directly responds to Anthem’s failed attempt to introduce time-based reimbursement caps.
In New Jersey, legislators have introduced a bill aimed at banning time limits on anesthesia reimbursement. State Sen. Carmen Amato and Assemblymen Greg Myhre and Brian Rumpf, all representing the state’s ninth district, introduced the measure following Anthem’s controversial proposal. The bill seeks to ensure that insurer policies do not undermine access to full anesthesia coverage.
Washington state lawmakers are advancing bipartisan legislation to prohibit time caps on anesthesia reimbursement. The bill would immediately ban insurers from denying coverage or capping reimbursement based on the duration of anesthesia during a procedure.
Additionally, the bill would empower the Office of the Insurance Commissioner to enforce compliance through monetary penalties, license revocations or suspensions, and public disclosure of violations on the commissioner’s website.
