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Anthem Reverses Course, Won’t Implement Rule to Cut Surgeries Short

The backlash was severe, pointing to the power of an organized voice

Zachary Walston, PT, DPT, OCS
In Fitness And In Health
5 min readDec 11, 2024

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Photo by Jannes Jacobs on Unsplash

Just when I thought insurance companies couldn’t stoop any lower, Anthem announced one of the most absurd policies to date.

On, December 4th, Anthem announced a new rule that would put a limit on the amount of time anesthesia is covered. So, if a surgery progressed beyond a set time limit, the insurance company would end its reimbursement and send the rest of the bill to the patient. They planned to pilot this new policy in Connecticut, New York, and Missouri.

Yes, you read that correctly. If you are getting surgery, and the surgeon notes a complication that would require an extension on the duration of the surgery (not uncommon given the large variability between people and conditions), the surgeon would be faced with two options.

  1. Stop the surgery at the time limit, regardless of the progress or danger it poses (not a realistic option)
  2. Complete the surgery and let the patient know (after they wake up) that a large bill is imminent.

Anthem claimed “it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services. The proposed…

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In Fitness And In Health
In Fitness And In Health

Published in In Fitness And In Health

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Zachary Walston, PT, DPT, OCS
Zachary Walston, PT, DPT, OCS

Written by Zachary Walston, PT, DPT, OCS

A physical therapist helping you understand and apply the latest health research | https://www.tiktok.com/@zachwalstondpt

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