The bill would bar group and individual health plans, including Medicaid managed care plans, from using arbitrary time limits to reimburse anesthesia during medically necessary procedures. Payment would be based on medical necessity as assessed by an anesthesia provider, and plans could not deny payment solely because care lasted longer than a preset limit. The Department of Health and Human Services Inspector General would audit insurers, investigate reported violations, and report to Congress.
If enacted, the bill would protect coverage for medically necessary anesthesia from denial based only on how long the care lasts. It would apply to covered patients with group or individual insurance and Medicaid, including Medicaid managed care.
No publicly available information.
The bill's findings state that anesthesia care should be based on medical necessity, and that time caps can threaten patient safety, create financial burdens, and interfere with medical decisions.
No publicly available information.