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Lawmakers hear bill to ban insurer time‑limits on anesthesia payments after national carrier proposals raised alarms
Summary
Delegate Ashanti Martinez and medical witnesses told the committee a bill is needed to block insurers from imposing fixed time limits on anesthesia coverage because such limits could pressure surgical teams, compromise patient safety and shift costs to hospitals; anesthesiologists, nurse anesthetists and hospital clinicians urged passage.
House Bill 10-86 would prohibit insurers and Medicaid/Medicare plans operating in Maryland from implementing policies that impose fixed time limits on payment for anesthesia services provided during medical or surgical procedures.
Sponsor Delegate Ashanti Martinez told the committee that arbitrary insurer time limits can leave patients financially liable for care beyond a carrier’s limit and create incentives that could affect clinical decision‑making. Dan Shattuck, executive director of the Maryland Society of Anesthesiologists, and multiple clinician witnesses described instances elsewhere where carriers proposed limits and said the practice threatens patient safety and full clinical care. Dr. Michael Webb, an anesthesia medical director, told the committee an insurer‑imposed timer would create pressure on surgical teams and could lead to rushed care; he said, “If a surgeon is under undue stress because of time, mistakes are gonna be made.”
Witnesses emphasized that anesthesia care extends beyond the minutes a patient is on the operating table: it includes pre‑operative evaluation, intraoperative monitoring, and post‑anesthesia recovery and orders. Physicians noted that some patients require invasive monitoring and extended preparation that can add an hour or more before incision; time limits that pay only for a narrowly defined window would not reflect the full scope of care. Several witnesses also said current Medicare payment rules and professional coding practices regulate billing but that statutory protection would be prudent given recent carrier behavior in other states.
Anesthesiology organizations said the bill is prophylactic: six other states have pursued similar legislation and some carriers briefly imposed limits in other markets before rescinding them after provider and public outcry. Witnesses raised workforce concerns: Maryland already faces shortages of anesthesia providers in some settings, and unreliable or capped reimbursement could worsen recruitment and access.
Ending: The committee closed the hearing after questions. Members asked clarifying questions about fraud‑control safeguards and about the potential effect on academic medical centers; clinicians said existing Medicare rules and joint commission oversight mitigate fraud risk and that time limits would especially burden centers with complex, teaching‑hospital case mixes.
