New York State Bill Amendment Imposes Time Limit on Anesthesia Care and Puts Patients’ Lives at Risk

CHICAGO – The American Society of Anesthesiologists (ASA) firmly opposes the surreptitious maneuver labeled a “hidden clause” or “concealed term” that was added to New York State Assembly Bill A5375-A and Senate Bill S7918-A, which allows health insurers to “use a time related reimbursement methodology for anesthesia services.”

Last year, ASA fought strongly against and stopped an unprecedented policy launched by Elevance Health, Anthem Blue Cross Blue Shield (BCBS), in certain states where the insurer unilaterally declared it would no longer pay for anesthesia care if the surgery or procedure went beyond an arbitrary time limit, regardless of how long the surgical procedure took. Public outrage and comment almost universally opposed the Anthem BCBS money grab, including New York Gov. Kathy Hochul in her social media post on Dec. 4, 2024, saying, ‘Outrageous. I’m going to make sure New Yorkers are protected.’ This hidden amendment in bills A5375-A and S7918-A will legally allow insurers in New York to arbitrarily predetermine the time allowed for anesthesia care during surgery or a procedure.

“This added ‘hidden clause’ is designed to mislead rank and file legislators to continue thinking they are banning this nefarious arbitrary practice, but it actually does the complete opposite. It allows insurers to predetermine the time allowed for anesthesia care during surgery or a procedure, which is ridiculous,” said ASA President Donald E. Arnold, M.D., FACHE, FASA. “If an anesthesiologist submits a bill where the actual time of care is longer than allowed, the insurer will deny payment for the anesthesiologist’s service. With this newly added language, insurers will be allowed to deny payment to anesthesiologists for delivering safe and effective anesthesia care to patients who may need extra attention because their surgery is complex, difficult, unusual or a complication arises. Once again, big insurance is working to place profits ahead of patients, this time through a tricky political maneuver.”

Anesthesiologists provide individualized care to every patient, carefully assessing the patient’s health prior to surgery, looking at existing diseases and medical conditions to determine the resources and medical expertise needed. They also attend to the patient during the entire procedure, resolve unexpected complications that may arise and/or extend the duration of the surgery, and work to ensure the patient is comfortable during recovery.

Payment for anesthesia services is based on several factors, including the exact amount of time for anesthesiologists to deliver care preoperatively, during the operation, and when transitioning the patient to the recovery unit afterwards.

“This amended bill is designed to take advantage of the commitment anesthesiologists make thousands of times each day to provide their patients with expert, complete and safe anesthesia care,” said New York State Society of Anesthesiologists Board Member Jonathan S. Gal, M.D., MBA, MS, FASA. “This egregious amendment breaks the trust between New Yorkers and their elected officials who they expect to protect their safety and pay physicians for the entirety of the care they need.”

ASA urges New Yorkers concerned about this bill to contact their state legislator.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 59,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. Follow ASA on Facebook, X, Instagram, Bluesky, and LinkedIn.

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