Discriminatory Anesthesia Reimbursement Policy Dropped After AANA Action

ROSEMONT, Ill. – The American Association of Nurse Anesthesiology (AANA) welcomes the reversal of a discriminatory anesthesia reimbursement policy enacted by Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. Under the policy, reversed after AANA loudly opposed and drew public attention to its implementation, Kaiser would 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 Certified Registered Nurse Anesthetists (CRNAs), also known as nurse anesthesiologists and nurse anesthetists to 85% of the Physician Fee Schedule, as reported by Becker’s Clinical Leadership.

The abrupt policy reversal comes two days after AANA President Jan Setnor, MSN, CRNA, Col. (Ret), USAFR, NC. released a statement condemning the policy.

“Like other recent policy reversals, the news that Kaiser will walk back their new anesthesia reimbursement policy is appropriate albeit late. This policy – and those similar – never should have been implemented in the first place. Expanding and ensuring access to timely, quality care should always be the priority and these dangerous policies stand in direct opposition to patient needs.

“AANA continues to call on Kaiser and other commercial payors to do the right thing by abandoning these discriminatory policies and instead prioritize and support patient care. We also continue to call on HHS to enforce the provider nondiscrimination provision of the ACA, as commercial payors need to be held accountable to the law. Enforcement of this provision is crucial to protect patients’ access to care and help lower healthcare costs for American patients and their families.”

Earlier this year, AANA filed a petition for a writ of mandamus in the United States District Court for the Northern District of Ohio asking the court to compel HHS Secretary Xavier Beccera to enforce the provider non-discrimination provision of the Affordable Care Act (ACA) against insurance companies and health plans. This is a duty that he is legally obligated to perform.

The provider nondiscrimination provision in the ACA was passed to prohibit health plans/health insurance companies (commercial payors) from discriminating against providers based on licensure, including setting up different reimbursement policies for those providers delivering the same high-quality healthcare services. In 2020, the No Surprises Act required the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury to issue rules and enforcement policies within one year. However, there is still no level of enforcement in place. Until this is completed, commercial payors like Kaiser can jeopardize patients’ access to care through discriminatory policies.

“CRNAs administer more than 58 million anesthetics and pain management services each year to patients in the U.S.” Setnor concluded. They are involved in every aspect of anesthesia in all types of settings – especially in rural areas.”