Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures
CHICAGO – In an unprecedented move, Anthem Blue Cross Blue Shield plans representing Connecticut, New York and Missouri have unilaterally declared it will no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes. The American Society of Anesthesiologists calls on Anthem to reverse this proposal immediately.
Anesthesiologists provide individualized care to every patient, carefully assessing the patient’s health prior to the surgery, looking at existing diseases and medical conditions to determine the resources and medical expertise needed, attending to the patient during the entire procedure, resolving unexpected complications that may arise and/or extend the duration of the surgery, and working to ensure that the patient is comfortable during recovery.
The Centers for Medicare & Medicaid Services (CMS) is committed to creating a robust Marketplace Open Enrollment process for consumers so they can effortlessly purchase high-quality, affordable health care coverage. CMS reports that nearly 988,000 consumers who do not currently have health care coverage through the individual market Marketplace have signed up for plan year 2025 coverage.
Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.
The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.
Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2025. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.
The deadline to select a plan for coverage beginning January 1, 2025 is December 15, 2024. Consumers who select a plan between December 16, 2024 and January 15, 2025 will have coverage beginning February 1, 2025.
Biden-Harris Administration Announces Medicare Advantage and Medicare Part D Prescription Drug Proposals that Aim to Improve Care and Access for Enrollees
Today, the Centers for Medicare & Medicaid Services (CMS) is proposing actions in the Medicare Advantage (MA) and Medicare Part D prescription drug programs to continue to strengthen protections and access to care for people with Medicare. The Contract Year (CY) 2026 MA and Part D proposed rule aims to hold MA and Part D plans more accountable for delivering high-quality coverage so that people with Medicare are connected to the care they need when they need it.
Covered California announced the first-year results of its first-in-the nation health plan accountability program, the Quality Transformation Initiative(QTI), today at its board meeting.
The QTI — aimed at improving health care outcomes and reducing disparities for members — was created with input from consumer advocates, health care providers and health insurance companies. It was developed in collaboration with the Department of Health Care Services and CalPERS.
The QTI establishes direct and substantial financial incentives (up to 1 percent of premium in the first year, rising to 4 percent of premium in future years) for all Covered California health insurance companies by requiring payments for failing to meet specified benchmarks for a focused, meaningful set of health-outcome measures. These equity-centered outcome measures include blood pressure and diabetes control, colorectal cancer screening and childhood immunizations.
Now is a great time to sign up for health and dental insurance
Open enrollment now through Jan. 15; 2024 election results do not affect 2025 coverage
Open enrollment on Washington Healthplanfinder™, the state’s marketplace for private health and dental insurance, is going strong and coverage for 2025 is unchanged by the results of the 2024 election. Through Washington Healthplanfinder, operated by Washington Health Benefit Exchange (Exchange), Washingtonians can choose from a variety of plans available in all regions across the state and access more savings than ever before.
