Nearing the end of 2024, several insurance companies proposed reducing reimbursements for anesthesia services, particularly claims from certified registered nurse anesthetists.
In November, Anthem Blue Cross Blue Shield said it would deny anesthesia claims for cases in New York, Missouri and Connecticut that exceed CMS' definition of physician work time values. The implementation was scheduled for February, but the payer on Dec. 5 said it was scrapping that plan.
However, Anthem and Cigna said they will reimburse CRNAs 15% less than other providers for the same anesthesia services, according to the American Association of Nurse Anesthesiology. The organization, which has a membership of 65,000, has asked a federal court to compel the payers to reverse course.
Kaiser Foundation Health Plan of Washington stopped reimbursing anesthesia services without identifying who performed the service, and CRNAs' reimbursements were reduced to 85% of the physician fee schedule. The change took effect Nov. 1, but by mid-December, Oakland, Calif.-based Kaiser reverted to its original policy.
"As one of the largest not-for-profit healthcare providers in the country, Kaiser Permanente’s mission is to provide high-quality, affordable care to our members and the communities we serve," a Kaiser spokesperson told Becker's on Dec. 12. "While we will continue our focus on keeping care affordable for our members, we will not implement changes in reimbursement rates for anesthesia services provided by certified registered nurse anesthetists."
Most recently, Medical Mutual, an insurer based in Ohio, said it will reduce CRNA reimbursement to 85% of fee schedule, effective Jan. 24.
"This policy announcement is a blatant, dangerous, and self-serving attack on CRNAs and the patients they seek to care for," AANA President Jan Setnor, MSN, CRNA, said in a statement.
Becker's has reached out to Medical Mutual for comment and will update this article if more information becomes available.