AANA Issues Statement on Cigna Reimbursement Policy

Rosemont, Ill.  (AANA)—The American Association of Nurse Anesthesiology (AANA) issued the following statement in response to Cigna Healthcare’s announcement that effective March 12, 2023, it will not reimburse anesthesia services when submitted without the appropriate modifiers identifying who performed the service and that it will be reducing QZ services rendered by a CRNA to 85% of the Physician Fee Schedule:

AANA strongly opposes Cigna HealthCare’s reduction of CRNA anesthesia reimbursements to 85% of the Physician Fee Schedule. This nationwide reimbursement reduction clearly discriminates against CRNAs based on their licensure because the policy does not affect any other anesthesia providers who offer the same services as CRNAs. This new anesthesia reimbursement policy will devastate healthcare delivery because it directly conflicts with the existing federal provider nondiscrimination law for commercial health plans, encourages higher-cost healthcare delivery without improving quality, and impedes access to healthcare for patients, especially in rural and underserved areas.

In some states, CRNAs are the sole anesthesia providers in nearly 100 percent of rural hospitals. Rural areas depend disproportionately on CRNA services for anesthesia and pain management care, affording these medical facilities obstetrical, surgical, trauma stabilization, and pain management capabilities. Without CRNAs to administer anesthesia and pain management services in rural and underserved areas, where many of Cigna’s members reside, patients would lose access to vital treatment, which could result in poor healthcare outcomes, lower quality of life, and unnecessary costs to patients. This also penalizes facilities such as acute care hospitals, rural hospitals, and ASCs, who pay for the difference through higher anesthesia subsidies and stipends. Cigna is creating access to care barriers for an entire class of anesthesia care providers who furnish services to some of its most vulnerable patients. Moreover, it is encouraging the practice of using and billing for the services of higher-cost anesthesia providers without any demonstration of higher quality of care.

Cigna must ensure that its anesthesia reimbursement policies do not create barriers to accessing CRNA anesthesia care services nor restrain CRNAs from furnishing services at their full professional education, skills, and scope of practice. This is what Cigna’s members need and deserve.