Thursday, March 12, 2015

New York Tells Insurance Company To Pay For Anesthesia Services For Colonoscopies

The New York Attorney General's Office has ordered an insurance company to pay for anesthesia services rendered during colonoscopies. The State AG Eric T. Schneiderman penalized Emblem Health $25,000 for billing a patient for anesthesia after his screening colonoscopy. According to the Affordable Care Act, aka Obamacare, screening colonoscopies are part of the free health maintenance procedures that are mandated by the law.

The insurance company ran afoul of the law when a patient was billed $1,320 by an anesthesiologist who was not part of his insurance network. The company paid $924 but told the patient to pay the balance. That's when the patient lawyered up and called the AG's office. According to the Attorney General, anesthesia is a necessity when a patient undergoes colonoscopy. Therefore, as required by the ACA, the patient does not have to pay any deductibles, copays, or coinsurance.

What can we take away from this? One, that anesthesiologists should get down on their knees and thank their deity of choice for the ACA. Now, when patients who have these government insurance plans come in for colonoscopies, their anesthesia bills can't be denied as so many private insurance companies try to do.

What is more amazing to me though is the obscene amount of money the anesthesiologist is billing. A colonoscopy typically takes no more than ten to fifteen minutes. In the hands of an efficient or unscrupulous gastroenterologist, seven or eight colonoscopies can be knocked out in an hour. If this anesthesiologist is able to collect that much money on each one, it's easy to see why some anesthesiologists truly have the best paying job in America.

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